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NUTRITION 
AND SPECIFIC THERAPY 



THE MACMILLAN COMPANY 

HEW YORK • BOSTON • CHICAGO • DALLAS 
ATLANTA • SAN FRANCISCO 

MACMILLAN & CO., Limited 

LONDON • BOMBAY • CALCUTTA 
MELBOURNE 

THE MACMILLAN CO. OP CANADA, Ltd. 

TORONTO 



NUTRITION 
AND SPECIFIC THERAPY 



BY 

DOROTHY E. LANE, S.B. 



i12eto gotft 
THE MACMILLAN COMPANY 

1922 

All rights reserved 



PRINTED IN THE UNITED STATES OF AMERICA 



^ 



V\^ 



.V 



1> 



Copyright, 1922, 
By THE MACMILLAN COMPANY. 



Set up and printed. Published May, 1922. 



Press of 

J. J. Little & Ives Company 

New York, U. S. A. 

m 24 1922 
©CU674240 






To The Memory of My Husband 
MICHAEL A. LANE 

SCIENTIST, SOCIOLOGIST, SCHOLAR 
AND LEADER 

I DEDICATE THIS BOOK 

"Strong like the sun, and like the sunlight kind, 
Heart that no fear, but every grief might move 
Wherewith men's hearts were bound of powers that bind." 

Svrinburne. 



PREFACE 

The many demands during the past seven years for a 
book, based on my dietetic lectures to students, have 
prompted me to gather my material, and publish it in this 
little volume. 

The book is the result of my own convictions and experi- 
ments, based, except where the author is quoted, on scien- 
tific facts and the researches of many of the best authorities 
of the world. 

To the reader, the chapters discussing the cooking of 
foods, the value of milk as an article of diet both for chil- 
dren and adults (infants excepted), and the chapter on a 
meat diet, may appear somewhat reactionary. But to these 
readers I wish to say that it is due to my somewhat radical 
convictions that my experience with diet patients has been 
successful. 

I have endeavored to present the subject matter in a very 
concise and practical form, and to give some information 
which possibly cannot be found as yet in other books of 
this nature. With this in mind, the chapters have been 
written on Auto-intoxication, Bacteriology of the 
Digestive Tract, Reforming the Intestinal Flora, 
and Vit amines, subjects which are of vital importance 
taken in conjunction with the study of nutrition. The 
hope is entertained that these chapters, together with the 
chapters on Diet in the Common Diseases, and In- 
fants' Diets; Children's Diets, based on many of the 
most recent researches, if not convincing — either through 
omission or error on my part — may prove to stimulate in- 
terest and many questions. The remaining chapters have 
been planned to lend interpretation to these subjects. 

vii 



Vlll 



PREFACE 



I wish to express my deepest appreciation of the great 
inspiration that my husband's companionship afforded me 
in my work, and of the reports on clinical cases, from his 
pathological laboratory, based on the results of my diets, — 
without these much of the material in this book would 
have been impossible. 

Dorothy E. Lane 

March 19, 1922 



CONTENTS 

CHAPTER PAGE 

I. Explanation of the Subject of Nutrition . 1 

II. Food Preparation 20 

Raw Foods and Effects of Cooking upon 
Foods and Conclusions 

III. Meat or Mixed Diet versus Vegetarian or 

Lacto- Vegetarian Diet .■."... 29 

IV. Auto-intoxication 46 

V. Bacteriology of the Digestive Tract . . 58 

VI. Eeforming the Intestinal Flora ... 65 

VII. Diet in the Common Diseases 76 

VIII. Infants' Diets; Children's Diets ... 96 

IX. Vitamines .136 

X. A Few Healthful Recipes; Some Invalid 

Recipes 150 

Miscellaneous Subjects 

Index . 177 



NUTRITION 
AND SPECIFIC THERAPY 



NUTRITION AND 
SPECIFIC THERAPY 

CHAPTEK I 

EXPLANATION OF THE SUBJECT OF NUTRITION 

We hear and read that God intended the human race to 
eat certain foods, while others He did not create for human 
consumption. But it is a known fact that the great major- 
ity of people eat what they like and want, what environ- 
ment and habit have accustomed them to demand, regard- 
less of what is best for their bodies, and they exert a vast 
amount of labor in making many God-made natural foods 
as unnatural and artificial as possible. 

The study of evolution proves the human race is what it 
is to-day because of its reactions to environment, and the 
foods it has eaten. Had man cultivated and eaten, of his 
own free will, other foods than those he has chosen, he 
would be a very different organism than he is to-day. 

The study of immunology teaches that some people are 
immune to certain diseases, while others are not. This 
fact is also a result of the reactions of man to environment 
and of the chosen foods. What is food for one man is 
many times poison for another in the same locality, and in 
different environments under different conditions of living 
there is much diversity in the foods favored, or those relied 
upon through necessity. Strawberries, for example, are 

1 



2 NUTRITION AND SPECIFIC THERAPY 

a food for one person, but a poison for another in the same 
town. Again, a person can digest some foods on a cold 
day that cause nausea on a hot day. It is well known many 
people are immune to certain diseases in summer, but are 
very susceptible to them in winter. 

It must be concluded that man to-day is what he is 
because of his habits through countless ages, and there- 
fore, he will be to-morrow and in the far future a result 
of what his habits are to-day. So. it is of the greatest 
importance that he choose the foods that are best for his 
own particular body in the environment in which he lives. 

This is what the subject of nutrition teaches. It ex- 
plains the composition of foods, how much heat and 
energy they produce, and how much new tissue they build ; 
it tells about the digestibility and assimilation of foods; 
it takes up the subject of age, sex, occupation, and climate 
in relation to the different foods; and lastly it considers 
the food question in relation to diseases. 

In order to do justice to this subject of nutrition and 
therefore to the human body, it is absolutely necessary to 
have a certain amount of knowledge of inorganic, organic, 
and physiological chemistry, of bacteriology and pathology. 
The lack of knowledge in these subjects accounts for much 
of the confused literature published on the food question 
and its relation to the body. With the above subjects in 
mind, the meaning of food composition should first be 
considered. 

Food Composition. — All foods are composed of the so- 
called five food principles, — protein, fat, carbohydrate, 
mineral matter and water, or any combination of these. 

Protein is a combination of the elements carbon, hy- 
drogen, oxygen, nitrogen, generally sulphur, and some- 
times phosphorus and iron; or it is, in other words, a 
complex of amino-acids linked together, with generally 
sulphur united in probably several different ways, and 
sometimes phosphorus and iron. 



THE SUBJECT OF NUTRITION 



3 



There are many different kinds of simple proteins, and 
the variety of ways in which the different amino-acids are 
combined, determines the different kinds of proteins in 
foods. 

Amino-acids in Common Proteins (Hammarsten and Hedin). 1 



Glycocoll 

Alanine , 

Valine 

Leucine 

Isoleucine 

Serine 

Aspartic Acid. 
Glutamic Acid 

Cystine 

Phenylalanine. 

Tyrosine 

Proline 

Oxyproline 

Tryptophane . . 

Histidine 

Arginine 

Lysine 



Osborne 

and 
Clapp 



Legumin 



0.38 
2.08 
1.0 5 
8.0 

0.51 
5.3 
13.8 

3.75 
1.55 

3.22 



2.42 

10.12 

4.29 



Osborne 

and 

Clapp 



Hordein 



0.0 
0.43 
0.13 
5.67 



43.19 : 

5.03 

1.67 

13.73 



1.28 
2.16 
0.00 



Osborne 

and 

Guest 



Gliadin 



0.68' 
2.0 

3.38 
6.62 

0.13 
0.58 

43.66 
0.45 
2.35 
1.20 

13.22 

1.00 
0.61 
3.16 
0.00 



Osborne, 
Jones, 

Clapp 



Zein 



0.0 
9.79 

1.88 
19.55 

1.02 

1.71 

26.17 



6.55 

3.55-10 J 
9.04 



0.82 
1.55 
0.00 



e . Abderhalden and Babkin. 
7 Osborne and Jones. 
9 Abderhalden and Samuely. 
11 Kutscher. 

Take for example the legumin of peas, and the gliadin 
of wheat, — the former is lacking in isoleucine, cystine, 
oxyproline and tryptophane, while the latter is lacking only 
in isoleucine and oxyproline. (This fact is important and 
will be referred to later on.) There is the protein of bar- 
ley called hordein, the protein of corn called zein, the 
1 "A Text-book of Physiological Chemistry ." 



4 NUTRITION AND SPECIFIC THERAPY 

protein of milk called casein, the protein of egg called egg 
albumin, the protein of muscle called myosin, etc. The 
list of the many kinds of protein in foods is a long one. 

Proteins differ in another respect also which gives a very 
interesting and important classification,- — and in this they 
are divided into animal protein and vegetable protein. 
There is more nitrogen in vegetable protein and more car- 
bon in animal protein. The nitrogen of vegetable protein 
is not as well absorbed as the nitrogen of animal protein 
for two reasons — first, it is more or less surrounded by 
starch and cellulose and for this reason it is difficult for 
the digestive juices to penetrate to it, and secondly, some 
of the nitrogen seems to be tied up chemically in such a 
way that it cannot be so completely absorbed. These facts 
are some of the arguments put forth against vegetarian- 
ism. (The significance of these facts will be discussed in 
Chapter III.) Atwater and Bryant give the absorption 
of animal and vegetable proteins as follows : — 

Kind Protein Utilized 

Animal foods 97 per cent. 

Cereals 85 " " 

Dried legumes 78 " " 

Vegetables 83 " " 

Fruits 85 " " 

These two kinds of protein, animal and vegetable, how- 
ever, perform the same mission. They are called "tissue- 
builders." This is their purpose, but they are relied upon 
also to some extent, under certain conditions, to produce 
heat and energy for the body. Protein enters into the com- 
position of all the body fluids and is a part of every cell 
nucleus. No life can exist without it. Therefore, since 
it is of such great importance, the absorbing question 
arises, — how much protein does man need in his food each 
day? The answer is one that has called forth endless 



THE SUBJECT OF NUTRITION 5 

quantities of discussion and investigations, and will be 
considered in this chapter under the subject of the calorific 
value of protein. 

The following foods give this daily supply of protein : — 
meats, eggs, milk, cheese, cereals, legumes and nuts. Other 
foods contain a very much smaller proportion of protein 
— such as fruits, vegetables, roots and tubers, but because 
of their small amount of protein, they are not classified as 
protein foods. 

Fat is a combination of the elements carbon, hydrogen 
and oxygen. In other words, it is a compound of fatty 
acids with an alcohol. There are many different kinds of 
fats, depending upon the different fatty acids and alcohols 
of which they are composed. But the common fats of 
plants and animals are principally combinations of the 
fatty acids, oleic, palmitic and stearic with the triatomic 
alcohol glycerol (commonly called glycerin). The fats of 
fishes and of marine mammals contain other fatty acids 
than these and other alcohols than glycerol. When these 
fatty acids are combined with glycerol, they are called 
glycerides, — and when these three glycerides, triolein, tri- 
palmitin and tristearin, are combined in a fat, the melting- 
point of the mixture depends upon the amount of each 
glyceride present, — the greater the amount of tristearin 
present the higher the melting-point, and the greater the 
amount of triolein present, the lower the melting-point. 

The melting-point of common fats is as follows: 
(Taylor) 

Horse Fat 60°-65° C. (Has most tristearin) 

Mutton Fat 50°-55° C. 

Beef Fat 45°-50° C. 

Lard 35°-40°C. 

Human 35°-40° 0. 

Butter 30°-35°C. 

Olive Oil — 5° C. (Has most triolein) 



6 NUTRITION AND SPECIFIC THERAPY 

The melting-points of the fats have a great bearing 
upon their digestibility, for the lower the melting-point, 
the easier the digestibility. 

This is true of uncooked fats, but not true of fats when 
raised to the frying and smoking temperature. When fats 
are raised to this high degree of heat, they are decomposed, 
and substances are produced which are irritating to the 
stomach. Therefore, when fats are cooked and raised to 
the temperature of frying, the fats with the highest melt- 
ing-point are the most desirable because less of these irri- 
tating substances are formed. The frying temperature 
averages 350°-400° F. or l76°-205° C, which is far be- 
low the smoking temperature of the first fats in the follow- 
ing column. 

Average Smoking Temperature of Edible Fats 

Cotton-seed 233° C. 

Snowdrift 232° C. 

Crisco 231° C. 

Leaf Lard 221° C. 

Butter 203° C. 

A Much Used Lard 190° C. 

All persons familiar with cooking know there is much 
smoke produced when frying in butter or in a much used 
lard, and the reason is clearly shown in the above table, 
for the temperature necessary for frying is above the 
smoking temperature of butter and lard. In other words, 
when frying, Snowdrift, cotton-seed oil and Crisco are 
more desirable. The irritating substances formed are cer- 
tain free fatty acids and the aldehyde, acrolein. These are 
irritating to the stomach, but in the normal digestion of 
fats in the intestines, the free fatty acids are not irritating 
and, for the most part, are formed into soaps by uniting 
with sodium, potassium, calcium and magnesium. 

Fats are absorbed in the intestines to a large extent as 
soaps, and their ultimate end is to produce heat and energy 
for the body, and to form a certain amount of protective 



THE SUBJECT OF NUTRITION 7 

tissue. To supply this the following foods are important : 
— olive oil, butter, eggs, cheese, nuts and soy beans. 
(Cheese is included in the list, but not recommended.) 

The third food principle to consider is carbohydrate. 
It is a combination of carbon, hydrogen and oxygen, the 
same elements composing it as are found in fat, but the 
chemical arrangement of these elements is different. Car- 
bohydrates may be divided into four main classes, — mono- 
saccharides; disaccharides, trisaccharides, and tetrasaccha- 
rides; polysaccharides; and celluloses. The monosaccha- 
rides are the building blocks and are the simple com- 
pounds or sugars from which all the others are formed. 
The term disaccharides indicates there are two molecules 
of simple sugars, trisaccharides indicates there are three 
molecules of simple sugars, and tetrasaccharides indicates 
there are four molecules of simple sugars. In the poly- 
saccharides there is an indeterminate large number of 
molecules of primary sugars, while the celluloses are of 
still larger molecular dimensions. 

The following classification explains carbohydrates in 
detail : — 

1. Monosaccharides,. . . . 



Hexoses 

(CoHisOe) 



"Glucose (Dextrose or Grape 

Sugar) 
Fructose (Levulose or Fruit 

Sugar) 
Galactose 

l£os°f} LeSS Conjnon 
The monosaccharides, — bioses, trioses, tetroses, pentoses and 
heptoses are less commonly found than the hexoses. 

2. (a) Disaccharides, 1. Saccharose (Cane Sugar), — 

(CuHziOn) hydrolyzes to 1 molecule of glu- 

cose and 1 molecule of levulose 
through the action of heat and 
water in the presence of an 
acid, and the enzyme, invertase, 
the latter taking place in the 
intestines. 



8 NUTRITION AND SPECIFIC THERAPY 

2. Lactose (Milk Sugar), — hy- 
drolyzes to 1 molecule of galac- 
tose and 1 molecule of glucose 
in the intestines through the 
enzyme lactase. 

3. Maltose -{Malt Sugar), — hy- 
drolyzes to 2 molecules of glu- 
cose through the enzyme mal- 
tase in the intestines. It is 
formed through the action upon 
starch of diastase in malt, the 
ptyalin in saliva, and the 
amylase in the intestines, and 
in the partial hydrolysis of 
starch and dextrin by acids. 

4. Trehalose, — hydrolyzes to 2 
molecules of glucose. (Un- 
common.) 

5. Melibiose, — hydrolyzes to 1 
molecule of glucose and 1 mole- 
cule of galactose. (Uncommon.) 

(b) Trisaccharides,. .. . hydrolyze to 1 molecule each of 
(CisHsaOw) levulose, galactose and glucose. 

Raffinose is a sugar belonging to 
this class, and is found in molasses, 
in sugar made from beets, in bar- 
ley and in other grains. 

(c) Tetrasaccharides, . . hydrolyze to 2 molecules of galac- 
(C2JL2O21) tose, 1 of glucose and 1 of levulose. 

Lupeose in peas belongs to this 
class. 

'hydrolyze to mole- 
cules of dextrose 
through the action 
of acids and 
through the action 
of the ptyalin of the 
saliva and the amy- 
lase and maltase in 
the intestines. 
Certain gums hy- 
drolyze to molecules 
of a pentose or hex- 
Lose. 



Polysaccharides, 1. Starches. . 

(CeHioOs)* 

2. Dextrins 
(Products of starch hydrolysis) 

3. Glycogen 
(Chiefly of animal origin, but also 

found in certain fungi.) 

4. Gums. . 



THE SUBJECT OF NUTRITION 9 

5. Mucilages 

6. Inulin,. . . hydrolyzes to mole- 

cules of levulose. It 
occurs in the dande- 
lion, chicory and other 
vegetables. 

4. Celluloses, hydrolyze to molecules of dextrose 

(CeHioOs)^ through the action of heat and 

water and sulphuric acid, and 
through the action of the digestive 
enzymes of certain animals. 

The purpose of carbohydrates in foods is the same for 
the most part as that of fats, — to produce heat and energy. 
In digestion in the intestines they are all reduced to the 
simple sugars, — glucose, fructose and galactose with the 
exception of the celluloses which man does not digest, al- 
though these are digested by many animals. 

The following foods are the main sources of supply of 
carbohydrates, — sugars, cereals, legumes, roots, tubers and 
fruits. 

The combustions for the support of work first attack the 
carbohydrates of the body, and if these be present or supplied 
up to the need, work will be supported by combustion of car- 
bohydrate alone. The body burns sugar in preference to fat 
if choice be presented. The sugar reaches the tissues of com- 
bustion in thirty to fifty minutes after ingestion. 2 

In the absence of sugar, the body will burn fat (of the diet 
or fat from the body depots) for the support of work, though 
the efficiency is a little lower than in the case of sugar. For 
extreme exertions, however, fat is the better food, since it is 
possible to ingest in a day more Calories in the state of fat 
than in the form of sugar. The diet should, however, always 
contain enough carbohydrate to avoid acidosis, and to save the 
catabolism of excessive protein. 

In the presence of carbohydrate, the catabolism of protein is 
not modified or exaggerated by muscular work. Very exces- 

a Taylor, "Digestion and Metabolism." 



10 NUTRITION AND SPECIFIC THERAPY 

sive work, and especially work with untrained muscles, may 
lead to increase in total nitrogenous catabolism, but this is an 
abnormal reaction. Normally, work does not affect the pro- 
tein catabolism. In a word, physical work under normal 
conditions does not noticeably affect the up-keep and wear- 
and-tear of the cells. In the absence of carbohydrate and 
fat, heavy work can be supported on the combustion of exog- 
enous protein alone, but it is an exaggerated process, and 
under such circumstances, the endogenous protein catabolism 
is also exaggerated. 

The fourth food principle is mineral matter. It in- 
cludes principally the organic and inorganic salts of so- 
dium, potassium, calcium and magnesium. There are 
other salts which are present in exceedingly small amounts. 
Iron, iodin, and organic phosphorus and sulphur are 
sometimes classified as mineral matter, but should be 
properly termed "elements" for they exist as organic com- 
pounds. 

The principal inorganic acids are hydrochloric, sul- 
phuric, carbonic and phosphoric, and there are many or- 
ganic acids, principally tartaric, citric, malic, oxalic and 
benzoic. 

Mineral matter is absolutely essential to all living tis- 
sues and fluids, and for neutralizing poisonous and waste 
products. (See Chapters II, VI, VII, VIII.) 

Fruits and vegetables should be relied upon for the main 
supply of mineral matter. It is also found in a consider- 
able quantity in milk, cereals, legumes, eggs, nuts, roots 
and tubers, but these foods should be eaten principally for 
other purposes, previously stated. 

In other words, all fruits and vegetables have a certain 
amount of organic and inorganic salts, — elements such as 
sodium, potassium, calcium and magnesium, united with 
an organic or inorganic acid. (See page 11.) 

The fifth food principle is water. This serves the func- 
tion of carrying in solution gases and substances used in 



THE SUBJECT OF NUTRITION 11 

Organic Acids in Common Fruits and Vegetables 

Apple Malic 

Banana " 

Cantaloupe Citric 

Cherry Malic 

Cranberry Malic — Citric — Benzoic 

Currant Citric — Malic 

Gooseberry " " 

Peach Malic 

Watermelon " 

Spinach Oxalic 

Lettuce Citric 

the metabolism of all body cells. It also regulates the 
osmotic conditions of the body and likewise the tempera- 
ture of the body. 

Calorific Value of Foods. — The second subject to be con- 
sidered in the study of nutrition is the calorific value of 
foods. By a calorie in physics is meant the amount of 
heat required to raise 1 gram of water 1° C. But this is 
the small calorie. For measuring the heat value of food, 
the large Calorie is used which is the amount of heat re- 
quired to raise 1 liter of water 1° C. or 1 pound of water 
4° F. Take 1 gram of the food in question, — how many 
pounds of water will it raise 4° F. when burned, or, as it 
is termed, oxidized ? The result gives the calorific value 
of 1 gram of that particular food. 

These results were obtained by burning protein, fat and 
carbohydrate in a machine called a calorimeter and these 
three food principles have the same heat value in the body 
as in the calorimeter. 

The researches of Rubner were the first to give the fol- 
lowing figures : — 1 gram of protein has the calorific value 
of 4.1 Calories; 1 gram of fat has the calorific value of 
9.3 Calories; 1 gram of carbohydrate has the calorific 
value of 4.1 Calories. Mineral matter, cellulose and water 



12 NUTRITION AND SPECIFIC THERAPY 

have no calorific value, although they are of equal impor- 
tance in other ways. 

Therefore, protein, fat and carbohydrate are for differ- 
ent purposes, but in the end each is oxidized, and for every 
gram oxidized in the body, the stated heat values are ob- 
tained. 

Because fat gives about 2*4 times the energy of carbo- 
hydrate and protein is no reason why it should be eaten in 
greater quantities. Eat is excellent in cold climates to 
produce heat and energy. It can replace carbohydrate to 
some extent, but it cannot replace protein, a certain amount 
of which is absolutely necessary to the cells and fluids of 
the body. Fat and carbohydrate can be stored in the body 
when eaten in excess of the required needs, but protein can- 
not be stored, — what is eaten in excess of the required 
needs is excreted. This is one of the great reasons why 
just the right proportion of protein should be eaten daily, 
— neither too much, nor too little, and if either of these 
errors is committed, sickness of some nature generally 
develops. 

The best health is maintained on a mixed diet of pro- 
tein, fat and carbohydrate with the required amount of 
mineral matter, cellulose and water and an adequate sup- 
ply of vitamines. 

The question may occur to the student, — why does fat 
give so much more heat and energy than carbohydrate? 
The answer is found in the number of carbon atoms in the 
fat molecule, for there are about three times as many as 
in the carbohydrate molecule. The exact molecular weight 
of protein molecules is still a mystery. 

For those who wish to know how to obtain the calorific 
value of any particular food, the following rule is given, 
with illustrations. 

The calorific value of any amount of food is obtained 
by reducing the amount of food in question to grams; 
know the percentage composition of this food; multiply 






THE SUBJECT OF NUTRITION 13 

the amount of food in grams by the percentage composi- 
tion of each of the three food principles; multiply these 
results by the calorific value of each of the three food 
principles ; add the total Calories together. 

Koast Beef (Lean) — 2 ounces = 56 + grams 
Per Cent. 

Water 55.3 56 X -292 = 16 - 3 grams protein 

Protein 29.2 56 X -082 == 4.5 " fat 

Fat 8.2 16.3 X 4.1 Calories = 66.83 Calories 

Carbohydrate.. 0.0 4.5X9.3 " = 41.85 " 
Mineral Matter. 1.4 



108.68 " 
108.68 Calories in a slice of lean roast beef. 

Butter — % ounce = 14 + grams 
Per Cent. 

Water 9.1 14 X -013 = .18 grams protein 

Protein 1.3 14 X -829 = 11.60 " fat 

Fat 82.9 .18 X 4.1 Calories = .73 Calories 

Carbohydrate.. 0.0 11.60x9.3 " =107.88 " 
Mineral Matter. 6.7 



108.61 " 
108.61 Calories in % ounce butter. 

Bread — % ounce = 14 + grams 
Per Cent. 

Water 40.0 14 X -065 = .91 grams protein 

Protein 6.5 14 X -01 = .14 " fat 

Fat 1.0 14 x .512 = 7.16 " carbo- 
hydrate 
Carbohydrate .. 51.2 .91 X 4.1 Calories = 3.73 Calories 
Mineral Matter. 1.0 7.16 X 4.1 " = 29.35 " 
Cellulose 3 .14x9.3 " = 1.30 " 



34.38 " 
34.38 Calories in % ounce of bread. 

The question now arises, — how many Calories a day 
does a man, woman or child require to maintain perfect 
health? This brings up the subject of standard dietaries 
so much discussed with many differences of opinion. Age, 



14 NUTRITION AND SPECIFIC THERAPY 

sex, climate and occupation are important factors in de- 
termining the required number of Calories for a particular 
individual. A child requires far less than an adult be- 
cause of size, but again he requires more because he is 
growing; women require a little less than men; less food 
is required in a warm climate than in a cold climate; a 
hard working laborer requires more than a brain-worker. 

The old standard dietaries for an adult doing an average 
amount of work advocated about 100 grams of protein, 
50-100 grams of fat and 500 grams of carbohydrate. But 
the most recent standards give figures much lower, per- 
haps half this number, although there still is much diver- 
sity of opinion. Professor Chittenden of Yale has proved 
by laboratory experiments that it is possible to maintain 
life and do a certain amount of work upon 50-57 grams of 
protein a day. Professor Henry C. Sherman of Columbia 
University gives the figure of 45 grams of protein for a 
man weighing about 150 pounds. These figures are both 
low compared with those of Voit, Hutchison, Benedict, 
Meltzer and Cohnheim, whereas the figures of Folin's ex- 
periments range between the highest and lowest standards 
for protein requirement. Rubner has even declared that 
nitrogen equilibrium can be maintained on 35 grams of 
protein a day for a person of average weight, while Klemp- 
erer has obtained nitrogen equilibrium on 33 grams. 
Landengren, then Siven, Cedercreutz and Ernberg con- 
firmed this low figure by an entirely different method. The 
figures of Hindhede are also extremely low. 

The latest and probably the best calculated figures range 
around 2,400 Calories a day from the three food prin- 
ciples, — protein, fat and carbohydrate. This figure dem- 
onstrates that scientific research acknowledges people have 
been eating far too much for health, and that man requires 
far less food than has been imagined. Herein lies part of 
the great secret to banishing many diseases which will be 
discussed in other chapters. Diabetes may bo cited here 



THE SUBJECT OF NUTRITION 15 

as an example, for it is much more prevalent among obese 
people than those of average weight. 

A very satisfactory rule in the author's work to deter- 
mine the number of Calories required a day for any per- 
son in health doing moderate work is the following : — 

Multiply the body weight by 1.3 to obtain the number 
of Calories of protein required a day. From this figure 
it is a very simple process to determine the number of 
grams of protein this figure represents, — simply divide 
the number of Calories of protein by 4.1 and the result is 
the number of grams of protein. 

A person weighing 150 pounds would require 150 X 1.3 
Calories of protein = 195 Calories of protein. Divide 
this figure by 4.1 and the result is about 48 grams of pro- 
tein a day. However, if the person is a brain-worker, this 
figure should be even less. In other words, one-half pound 
of English walnuts would give the total protein require- 
ment a day for this person. But many people do not con- 
sider one-eighth of a pound of nuts at the end of the third 
meal of the day as a food of any importance, — it is merely 
a finishing touch. When the protein intake from bread, 
butter, eggs, cereals, salad, meat, milk, potato, legumes, 
vegetables and fruits, that the majority of people eat in 
their three meals daily, is calculated, the number of guilty 
parties who have violated one of the laws of health would 
be enormous. 

It is the author's opinion that if the number of Calories 
of protein for each particular person is accurately calcu- 
lated, the carbohydrate and fat Calories take care of them- 
selves to a large extent. The protein Calories should be 
kept about the minimum, — in other words, "nitrogen 
equilibrium" should be maintained which means that the 
intake of protein should equal the amount excreted, — any 
quantity above or below this is harmful. When it is said 
the fat and carbohydrate Calories will take care of them- 
selves, this does not mean a person can indulge in quanti- 



16 NUTRITION AND SPECIFIC THERAPY 

ties of commercial, concentrated, animal and vegetable fats, 
and sugars in the form of candies, pastries and sauces. 
One of the purposes of this book is to demonstrate that 
such foods are unnatural and many times harmful in many 
ways. Man requires many more Calories of carbohydrate 
than of protein or fat, but if the Calories of protein are 
carefully figured, a man may eat as much fat and carbo- 
hydrate food in a natural form as he desires to satisfy 
his appetite, and need not calculate their Calories, and 
will not go far astray. (Cane sugar and cream cheese are 
examples of commercial, artificial foods.) 

In closing the discussion on Calories, it is fitting to call 
attention to a special kind of advertisements one reads 
everywhere in connection with the calorific value of foods. 
It is stated a certain number of Calories in a certain food 
costs a very few cents, and that the same number of 
Calories in other foods costs many times more. However 
excellent such a food may be, it cannot claim all the ad- 
vantages of a mixed diet. 

The entire aim in eating is not a question of obtaining 
the greatest number of Calories ; the aim is to obtain the 
required amount of "complete protein" to maintain nitro- 
gen equilibrium, a sufficient amount of carbohydrate and 
fat for heat and energy, a balanced mineral ration for the 
body's fluids and cells, and for neutralizing waste products, 
an adequate supply of the three or more vitamines neces- 
sary for growth and health, and a generous amount of 
cellulose to create active peristalsis. In other words man 
cannot live on a single article of food and maintain health, 
for there is no article of food that will supply the needs 
enumerated, except the mother's milk for the nursing 
infant. 

Digestion and Assimilation of Poods. — This subject 
will close the chapter outlining the explanation of the 
subject of nutrition except for diets in special diseases 
which will be discussed in different chapters. 



THE SUBJECT OF NUTRITION 17 

By digestion is meant the ease with which the food is 
disposed of in the stomach. 
This is dependent upon : — 

1. Kinds of Foods ; 

2. Preparation of Foods; 

3. Combination of Foods. 

The order in which different kinds of foods leave the 
stomach are, — carbohydrate, carbohydrate plus protein, 
protein, fat, and lastly fat plus protein which accounts for 
the delay of fried foods in the stomach. 

Some protein foods require more pepsin than others, — 
for example, the gluten of bread requires five times as 
much pepsin as the casein of milk, but this fact does not 
necessarily mean that it takes five times as long for bread 
to leave the stomach, for some foods cause the gastric 
juice to flow faster than others. 

It is therefore evident that when there is a great variety 
of food in the stomach, there is "indigestion" of some 
kind; for the food is delayed in its digestion and this 
always indicates bacterial fermentation or putrefaction. 
(See Chapters IV, V, VI.) 

The conclusion is this: — The less variety at one meal, 
the quicker the digestion, and the better for the health ; but 
the greater the variety, the three meals a day considered, 
the better for the health. Serve as few foods as possible 
at each meal, but serve generously of these foods, and vary 
each of the three meals a day, and the meals of each day 
of the week if possible. By following this rule, the seeker 
for health will obtain a "complete protein," sufficient fat 
and carbohydrate, a balanced mineral supply, an adequate 
amount of vitamines, and a generous proportion of cellu- 
lose. Variety is of the greatest importance in the ques- 
tion of health, and one of the primary reasons is because 
it provides a "complete protein" diet. Mendel, Osborne, 
McCollum, Hawk and others have devoted much of their 
time to researches along this line. 



18 NUTRITION AND SPECIFIC THERAPY 

There are twenty-six known ammo-acids derived from 
simple proteins required to keep the body in nitrogen 
equilibrium. Seventeen of these are the most common. 
Some foods contain only part of these, a very few contain 
all required for health, while still others may contain all, 
but not in the right proportion. The human body demands 
all these amino-acids, and in the required proportion. A 
varied protein food diet will insure this end. Foods known 
to contain a complete protein" are meat, milk, and eggs, — 
the soy bean 3 and peanut 4 (Rats were used in these ex- 
periments), coconut (See Chapter IX) and possibly the 
potato. Hindhede, 5 experimenting on men, also Thomas, 
Rose and Cooper (1917) have published extremely inter- 
esting information concerning the protein of the potato, 
and its power to maintain nitrogen equilibrium. McCol- 
lum 6 and his coworkers, however, in experiments on rats, 
conclude the nitrogen of the potato for growth has no 
greater value than an equivalent amount from corn and 
wheat. F. A. Cajori 7 has found many of our important 
nuts furnish ar adequate protein for rats. 

According to recent investigations by Sherman 8 and 
his collaborators the protein of wheat, corn and oats will 
keep the body in nitrogen equilibrium if 9/10 of the pro- 
tein is derived from these cereals, the remainder being fur- 
nished by apple or milk. These research men 9 also claim 
the proteins of oats and maize are of virtually equal nu- 
tritive value, and this is true whether the proteins con- 
stitute practically the sole nitrogen food or are supple- 
mented by a constant small amount of milk protein. 
Human subjects were used in these experiments. 

3 T. B. Osborne and L. B. Mendel, J. Biol. Chem., Dec, 1917. 

4 A. L. Daniels and R. Loughlin, J. Biol. Chem., Feb., 1918. 

5 "Protein and Nutrition." 

6 E. V. McCollum, J. Biol. Chem., Oct., 1918. 
V. Biol. Chem., Dec, 1921. 
V. Biol. Chem., Jan., 1920. 
9 J. Biol. Chem., Aug., 1919. 



THE SUBJECT OF NUTRITION 19 

Osborne and Mendel 10 conclude, in experiments on 
rats, there is evidence that the total proteins of rice and 
barley, in contrast with corn and oats, when furnished in 
diets containing 16 to 17 per cent of protein, supply 
enough of all the amino-acids for growth. 

The conclusion to be drawn from these researches is 
that not all of the evidence is absolutely conclusive, and 
that experiments on different animals and on men do not 
always prove the same facts. This statement can also be 
applied to many other researches, especially on vitamines 
and mineral matter. But a certain amount of the results 
can be accepted as facts, and the questionable results point 
to many future researches in these subjects. 

In conclusion, it may be said, the kind of food is of 
primary importance. The preparation of food should re- 
ceive fully as much attention. This brings up the ques- 
tion of cooked and uncooked foods, the effects of cooking 
on the food principles, and the most desirable methods of 
cooking to obtain the best results for health. 

10 J. Biol. Chem., June, 1918. 



CHAPTEE II 

FOOD PREPARATION 

Raw Poods and Effects of Cooking. — Heat coagulates 
protein, rendering both animal and vegetable protein less 
digestible at as low a heat as 170° F. or 77° 0. When 
the protein is coagulated, a longer time is required for 
the pepsin, activated by the hydrochloric acid, to reduce 
it to peptones ; and since this is true, the food may be de- 
layed in the stomach, and bacterial fermentation and putre- 
faction may develop to a greater or less degree. Again, 
the acidity of the stomach contents becomes greater the 
longer the food is delayed in the stomach, and this fact 
adds to the length of time the food remains in the stomach, 
should the acid fermentation from the bacteria develop. 
It may, therefore, be said there are three objections to 
cooking protein, the resulting coagulation, and possible 
putrefaction and excess acidity. 

Beef 

Raw digests in 2 hrs. Wholly-boiled digests in 3 hrs. 

Half -boiled digests in 2% hrs. Roasted digests in 3-4 hrs. 

Heat affects fat by causing a decomposition if it is 
raised to a sufficiently high temperature, with the libera- 
tion of free fatty acids and an aldehyde which are irri- 
tating to the stomach, and delay digestion. 

Dry heat changes starch into dextrin at 300° F. or 
149° C. and moist heat causes the cellulose which sur- 
rounds the starch granules to rupture and liberate the 
granules and these become swollen with water. The diges- 

20 



FOOD PREPARATION 21 

tive juices can then digest the granules much more readily, 
and therefore, the starch is more completely absorbed when 
cooked. But it cannot be said to be more digestible, for in 
the cooked state, it is more readily attacked by bacteria in 
the stomach, possibly causing fermentation which delays 
its digestion in the stomach. On reaching the intestines, 
this fermentation may continue. Sugars are unaffected 
by moist heat, except in the presence of acids. 

Cellulose is affected in much the same way by moist heat 
as starch, for it may be made a more favorable medium 
for bacterial fermentation, with the production of oxalic, 
butyric and acetic acids and others that are harmful. 
These facts bear laboratory proof. 

The great reason for cooking foods containing cellulose 
for the majority of people is to soften it. They think it 
is more digestible, perhaps better assimilated. Cellulose 
is not assimilated by man, for man has no enzyme either 
in the stomach or in the intestines to hydrolyze cellulose 
to dextrose. Man requires cellulose for bulk, and this is 
its greatest value, — that of promoting peristalsis. Cooked 
cellulose is far inferior to raw cellulose for promoting per- 
istalsis. If the digestion is normal, an abundance of fresh 
salads should be eaten. Fresh fruits should be thoroughly 
washed before eaten, but not pared. Grape skins and the 
skins of potatoes should not be discarded. 

Mineral matter in an inorganic form is not so readily 
affected by heat, but in the organic form, the changes are 
much more numerous, — it may be either thrown out of its 
organic combination, or it may be made from a soluble 
into an insoluble compound. An example of the latter is 
found in the boiling of lemon juice, when the citric acid of 
the lemon is changed from soluble tricalcium citrate into 
insoluble calcium citrate. Insoluble compounds some- 
times are more difficult of absorption. 

With these facts in mind, a very important question is 
presented. Is cooked or uncooked food the more desirable 



22 NUTRITION AND SPECIFIC THERAPY 

for health ? Naturally the answer is, — if heat coagulates 
protein, thus rendering it less digestible, and perhaps pro- 
moting bacterial action, it should be cooked as little as 
possible, or not at all. If protein foods are cooked, they 
should be cooked at as low a temperature and as short a 
time as possible. The greater the temperature at which 
they are cooked, the tougher and hornier they become. 
This fact is very clearly seen in the boiling of meat on the 
stove as compared with cooking it in a fireless cooker, and 
in the boiling of the white of an egg over the flame as 
compared with dropping the egg into boiling water and 
setting the pan on the back of the stove for 20 minutes. 

However, there is one great problem with which to con- 
tend. It is true that meat eaters must cook their meat to 
kill the bacteria contained in it, and the meat should be 
cooked until all rawness has disappeared. Underdone 
meats contain many pathogenic bacteria such as those of 
splenic fever, tuberculosis, malignant edema, septicemia, 
chicken cholera, — tapeworm, trichina, etc. 

It unquestionably follows that because heat at high 
temperatures decomposes fat with the liberation of irritat- 
ing substances they also should be eaten in their natural 
state or cooked at a low temperature. 

Since moist heat may prepare starches and celluloses 
for bacterial fermentation, and partly destroys the great 
value of cellulose for promoting peristalsis, these should 
never be cooked, except when absolutely necessary. Sol- 
uble starch and sugar is also lost many times in the differ- 
ent cooking processes. 

The student has been taught that starch grains must be 
liberated to insure perfect assimilation. The membranes 
enveloping raw starch grains have been regarded as im- 
pervious to digestive juices. So it has been taught that 
it is very desirable to cook starch, and it has been said no 
starch appears in the feces after a meal of well cooked 
bread, potato or legumes. Despite these traditional teach- 



FOOD PREPARATION 23 

ings, it has been found from recent investigations that raw 
starch is digested to a large extent. Langworthy and 
Deuel 1 have proved that raw starch granules are not swol- 
len or broken, yet ingested quantities exceeding 200 grams 
a day disappear from the intestines. Raw corn and wheat 
starches were found to be completely assimilated, — 78 per 
cent raw potato starch was assimilated. 

Since cooking throws mineral matter out of its organic 
combination many times, and also changes it at other times 
from a soluble into an insoluble compound, and since also 
much is lost in draining vegetables, cereals, legumes, roots 
and tubers in many of the cooking processes, the conclu- 
sion must necessarily follow that foods relied upon for 
their mineral content should not be cooked. 

Lastly, there are the enzymes and vitamines to consider 
in connection with cooking. Both are destroyed to a large 
extent, — some do escape, but why should the risk be taken 
of killing such vital substances ? ( See Chapter IX. ) 

With the above reasons in mind, it must be admitted 
raw foods have a great advantage over cooked foods for 
health. For instance, Instead of cooking oatmeal two to 
three hours as cook-books advise, cook it ten to twenty 
minutes. (A recipe is given in the last chapter.) 

Since cooking is almost universally the practice, the 
different methods of cooking many of the common foods 
are given in the following discussion: — 

Food Adulteration by the Consumer.- — Much has been 
heard about food adulteration by the producer and the 
many ways in which he has striven to delude the public 
into believing that it is obtaining money value in the prod- 
ucts purchased. Every one enjoys the satisfaction of 
knowing that he has received value for value. The fact 
is, however, that the producer is by no means the only 
party that may not give fair returns to the consumer, for 
the consumer may not give fair returns to himself. 

V. Biol Chem., May, 1920. 



24 NUTRITION AND SPECIFIC THERAPY 

If every home-maker in turn were asked how she pre- 
pares her vegetables, potatoes, cereals and legumes for the 
table the answer, aside from frying and baking, with but 
few exceptions, would be that in the case of potatoes they 
are peeled, thrown into boiling, salted water and cooked 
until tender ; they are then drained from their water, sea- 
soned and prepared in the various ways; in the case of 
spinach, celery, cauliflower, asparagus, cabbage, corn, peas 
and beans, the answer would invariably be that they are 
boiled in salted water till tender, and then drained. These 
facts are one of the great crimes of the culinary art, and 
show that the consumer adulterates the food and is cheated 
in nutritive value, flavor and cost. In this process of cook- 
ing, these foods lose in all their nutritive principles and 
absorb water in exchange. The food principles that are 
diminished mostly are the mineral matter, and carbohy- 
drate, while some vitamines are destroyed, or lost. 

Every home-maker would be horrified at the idea of 
throwing away the water in which fruits had been stewed. 
The fact is, however, that the water in which vegetables 
are cooked, which is generally thrown away, will average 
about the same in vitamines and mineral substances. 

The body's great need for mineral matter and vitamines 
in carrying on its vital processes is apparent. The skele- 
ton, muscles, nerves and blood all demand them, and the 
fruits and vegetables, principally, together with cereals, 
legumes, nuts, roots and tubers, and milk for infants, 
should be the chief source of supply. In these substances 
fruits and vegetables supplement the cereals, legumes, 
nuts, roots and tubers. (See Chapter IX.) 

The American people are suffering from lime starvation, 
a fact plainly seen in the general decay of the teeth. (See 
Dental Caries and Pyorrhea, Chapter IX. ) Milk has the 
largest proportion of calcium of any of our foods, and this 
is one of the reasons why it is recommended to so great an 
extent. Human milk contains the required amount for 



FOOD PREPARATION 25 

infants, but cow's milk should not be relied upon for cal- 
cium for adults, as there are other foods with an adequate 
supply that are far superior for adults, which will be dis- 
cussed in full elsewhere. 

M. S. Rose 2 says : — "It seems possible to meet the re- 
quirement of the adult human organism for calcium, 
largely if not wholly, from carrots." This statement illus- 
trates the importance of roots, tubers, fruits and vegetables 
as the principal sources of mineral matter. Cereals, 
legumes and nuts may be included, although they repre- 
sent three of our protein foods. 

It happens that calcium constitutes a larger proportion 
of the body than any other of the inorganic elements. To 
repeat: — It is required for bones, teeth, muscles, nerves, 
for the coagulation of the blood, for the digestive juices, 
and probably for many other functions. When the food 
consists principally of meat and cereals, the calcium re- 
quirement is not sufficient. But if the diet is rich in milk 
(recommended for adults only through necessity), yolk of 
eggs, legumes, fruits, vegetables, roots, and tubers, calcium 
equilibrium will be maintained. (See also Pellagra, 
Chapter IX.) 

Sodium is a very important element of the blood and 
fluids of the body. It aids in the formation of the hydro- 
chloric acid and other digestive juices. It is necessary for 
the formation of cartilage, it is found in the brain and it is 
necessary for the neutralization of waste products. 

Iron is a constituent of hemoglobin, necessary for the 
supply of oxygen. It forms a part of the nucleins and 
nucleoproteins. It is necessary for the action of certain 
enzymes. 

Iron derived from the hemoglobin of meat is not well 
absorbed, a fact which makes it all the more imperative 
that the preservation of fruit and vegetable iron should 
be guarded. 
V. Biol. Chem., March, 1921. 



26 NUTRITION AND SPECIFIC THERAPY 

Magnesium is important in the construction of bone 
and cartilage; it lends flexibility to the bones and con- 
tractility to the muscles. It also forms phosphates which 
are excreted in the urine. 

Potassium is necessary as a tissue base and is to the 
muscles and softer tissues what the calcium is to the bones. 
It likewise aids in neutralizing poisonous products of 
metabolism. 

There is practically no evidence that the body ever ab- 
sorbs any greater quantity of mineral matter than is re- 
quired in repair and elimination. If there is an accumu- 
lation in any particular tissue, the fault should be ascribed, 
in the majority of cases, to wrong diet first (many times 
a high protein diet), and the remedy should not be to re- 
duce the amount of mineral matter, but to correct the 
faulty diet. 

Since this mineral matter is so often lacking in the 
blood, and since the neutrality of the blood must be main- 
tained, the body tissues themselves in these cases are re- 
quired to give up their NH 2 groups, or inorganic elements, 
calcium for example, to neutralize the acids in the blood. 
Were this not the case, people would suffer much more fre- 
quently from acidosis than is now the case. However, if 
the body cells are called upon to continue this work, death 
is the result. 

For those who wish to eat cooked food, the important 
question is, — what are the ideal methods for cooking vege- 
tables, cereals, legumes, roots and tubers, foods that should 
be relied upon so extensively for their mineral content as 
well as for their carbohydrate, protein and vitamines ? 

For the sake of health, frying will be omitted and five 
methods will be considered in the order of their priority. 

1. (a) Boiling in so small a quantity of water that 
none is left for draining, — peeled potatoes cut 
up small, carrots, turnips, parsnips, peas, beans, 



FOOD PREPARATION 27 

lentils, spinach, cabbage, corn, celery, asparagus, 
onions, cereals. (Require close watching.) 

(b) Stewing in double boiler, — cereals and all suc- 
culent vegetables. 

(c) Baking, — any vegetable, root, tuber or legume 
and some cereals. 

2. Steaming with skins on, — roots and tubers. 

3. Boiling with skins on (draining necessary), — 
roots and tubers. 

4. Steaming (large vegetables), — corn on cob, 
cauliflower, roots and tubers. 

5. Boiling in large quantity of water and draining, 
— vegetables, roots, tubers, cereals and legumes. 

If this last method is employed, the water in which 
these foods were cooked should be saved and used for soups 
or sauces. 

In each of these processes the nutritive value and flavor 
in the end is different, and the one whereby none or the 
least water is drained off is the one that has retained the 
most nutritive value and flavor. 

The losses in nutritive value from boiling and draining 
are about as follows: — spinach loses 50 per cent mineral 
matter, cabbage 35 per cent, carrots 12 per cent. In 
steaming about 10 per cent is lost. 

This means a gain in the water content of these foods. 

Per Cent. Per Cent. 

Water in Water in 

Raw State Cooked State 

Parsnips 82.0 92.2 

Cabbage 89.0 97.5 

Spinach 90.0 98.0 

Cauliflower 90.1 96.4 

McCollum and Simmonds 3 make the following state- 
ment : — 

8 A. J. Physiol., June, 1918. 



«8 NUTRITION AND SPECIFIC THERAPY 

Young animals cannot grow when fed a single seed or a 
mixture of seeds, even though the latter is supplemented with 
purified protein and a fat containing fat-soluble A vitamine. 
The inorganic content is the first limiting factor, and sodium, 
calcium and chlorine must be added before growth becomes 
possible. 

Certainly these reasons in favor of preparing vegetables, 
cereals, legumes, roots and tubers with the greatest econ- 
omy, especially in mineral matter and vitamines, with the 
idea of the promotion and preservation of health, should 
appeal to every one as facts that cannot be neglected. 



CHAPTER III 

MEAT OR MIXED DIET VERSUS VEGETARIAN OR LACTO- 
VEGETARIAN DIET 

It has been said that the greatest value of meat lies 
in the fact that the quality of the albumin most nearly ap- 
proaches that of our own tissues. But this statement has 
very little significance because both animal and vegetable 
proteins are hydrolyzed to the same amino-acids before 
they can be absorbed. 

The statement has been made that a minimum protein 
diet for adults is necessary for health. The question may 
now be asked, — in what form should this protein be eaten, 
— should it be eaten as animal or vegetable protein ? This 
subject has been discussed by some of the most able minds 
of the day. 

The great naturalists, physiologists, and anatomists, 
Cuvier, Owen, Linnaeus, Ray, Hunter, Carpenter, Bell 
and others have declared that the structure of the teeth 
and stomach show men to be properly adapted to a diet not 
of flesh, but of fruits, nuts and grains. 

Most of the strongest, largest, longest lived animals are 
vegetarian, — the elephant, rhinoceros, buffalo, hippopota- 
mus, bison, bull, stag, camel and horse represent this class. 
"All the carnivorous beasts are prowlers and most of them 
are stupid/' 

The observation has sometimes been made that "great 
nations are flesh-eating, but these nations have risen to 
greatness on a simple diet, and have acquired riches, have 
eaten expensively, and after a few score or a few hundred 

29 



30 NUTRITION AND SPECIFIC THERAPY 

years, have fallen into decay.'' Length of life and activity 
in old age are certainly more common among frugal vege- 
tarians than among eaters of a mixed diet. 

It has been proved that men living on a vegetarian diet 
lack initiative and great energy, — yet they have untiring 
capacity for labor and are less nervous. A difference is 
also seen in animals. The panther paces wildly, but the 
elephant, camel and horse are comparatively reposeful 
and have wonderful endurance. 

William Lawrence, Professor of Anatomy and Surgery 
to the Royal College of Physicians, has said: 

The teeth of man have not the slightest resemblance to those 
of the carnivorous animals, except that the enamel is confined 
to the external surface. The teeth and jaws of men are in 
all respects much more similar to those of monkeys than of 
any other animals. The skull of the orang-utang has the first 
set of teeth, the number is the same as in man and the form 
so closely similar that they might be mistaken for human 
teeth. 

Man possesses a large cecum and a cellular colon which I 
believe are not found in any carnivorous animal. 

The carnivora have claws, a rasping tongue, pointed molar 
teeth, small salivary glands, a simple stomach, a smooth colon 
and an intestinal canal three times the length of the body. 
Man has nails, a smooth tongue, blunt molar teeth, well 
developed salivary glands, a stomach with a duodenum, a con- 
voluted colon and an intestinal canal twelve times the length 
of the body. The saliva in the carnivora is acid, in man it is 
alkaline. 

Bouchard and Charles Darwin have said that in ancient 
times man probably subsisted upon fruits. 

Darwin proved that man does not belong to the car- 
nivorous order such as the lion and the leopard, but to the 
herbivorous and frugivorous order such as the gorilla and 
the chimpanzee. Man's masticatory movements compare 
with those of the higher apes, while the jaws of the car- 



MEAT VERSUS VEGETARIAN DIET 31 

nivora work like giant shears. Herbivorous animals ae- 
crete much more saliva in proportion to their size, and they 
have a long alimentary canal while the carnivorous have 
a short one. In the carnivora the hydrochloric acid is 
much stronger in order to prevent putrefaction, and their 
liver is much more powerful. The herbivora have a sac- 
culated colon, while the carnivora have a smooth colon. 
The human alimentary canal is about ten times the length 
of the body, — that of the lion is only about four times the 
length of the body. 

This latter fact seems to prove that man requires a 
vegetarian diet which provides bulk in the form of cellu- 
lose for the intestines. Meat protein is hydrolyzed to pep- 
tones in the stomach, and has only one more stage to reach 
before it is ready for absorption, — a long intestine would 
seem to be entirely unnecessary for this final chemical 
change. But on a vegetarian diet, the protein, fat, carbo- 
hydrates, and mineral matter are surrounded by cellulose 
and the digestive juices cannot readily reach them. There- 
fore, a long intestine seems necessary to furnish plenty of 
time and space for the digestive juices to accomplish their 
work, and for the quantity of bulk necessary on a vegeta- 
rian diet. Much larger quantities of food must be eaten 
on a vegetarian diet than on a meat diet, as the food prin- 
ciples are not so concentrated. 

Frugiyorous and herbivorous animals can be made to 
live on flesh. This has been tried in the case of the pigeon, 
horse, monkey and other animals. 

Honorable R. Russell gives the following interesting 
facts concerning the diets of the different nations x : — 

It is estimated that three-fourths of mankind in all 
known periods have been practically vegetarian. There 
have been, however, a good many races which have sub- 
sisted largely on flesh and some almost wholly, — the Eski- 
mos and the Greenlanders for example. 

1 "First Conditions of Human Prosperity" ; "Strength and Diet." 



32 NUTRITION AND SPECIFIC THERAPY 

Professor Lawrence mentions the Lapps, Samoides, 
Ostiacs, Turgooses and Burats as living on flesh and as 
being among the weakest and least brave people of the 
globe. 

Sir John Sinclair, of the early part of the last century, 
describes the Tartars as living wholly on flesh. Their 
strength was great, but their character extremely low and 
ferocious. 

In the eighteenth century, the common food in Scot- 
land was brose, porridge, oatmeal, flummery and greens, 
boiled with a little salt. Beer or milk was drunk. Scarcely 
any flesh was eaten. Both men and women were robust 
and subject to few diseases ; none were of a nervous nature. 
In the lowlands of the north, to these foods were added 
some mixture of barley, rye or peas, potatoes, onions and 
butter. Brindley, the engineer, found that his workmen 
from Lancashire and Yorkshire whose fare was oat cakes, 
hasty pudding and water, did more work than the laborers 
of the south who ate bacon, bread, cheese and beer. In 
recent years the Scotch children have been fed on bread, 
tea and flesh and are not nearly as strong as formerly. 

The Norwegians used to live on bread made of mixed 
rye, barley and potato, and later on, rye and barley bread, 
milk and cheese and occasionally slices of fish. They were 
healthy, strong and long-lived. The young people were 
able with ease to run by a carriage going full speed for 
twelve miles. Cheese, smoked reindeer, bacon and fish 
are now much eaten. 

The staple food of the Swedish peasantry is rye bread. 
Milk and dairy products are abundant. The Swedes have 
been a fine strong race. 

In Germany as in England and most countries of the 
world, well-to-do people have for a long time eaten flesh 
in large quantities, but the mass of the population has sub- 
sisted chiefly on black bread, milk, peas, potatoes and other 
vegetables. 



MEAT VERSUS VEGETARIAN DIET 33 

The Flemish laborer has for breakfast, bread and butter, 
chicory, coffee and milk ; for dinner, he has potatoes, vege- 
tables and bread ; for supper he has the same. Very sel- 
dom a little bacon and other flesh is eaten. 

The Finns thrive chiefly on grain and vegetables, but 
also on some flesh. 

The Swiss peasantry have lived on bread, cheese, milk, 
potatoes, vegetables and fruits, with flesh rarely in the 
country and frequently in the towns. 

The government reports on dietaries of the laboring 
people of Europe in 1872 show that in most countries the 
fare was almost entirely non-flesh, but that in several coun- 
tries flesh was eaten occasionally, as once a week or on 
Saints' days. 

The Russians have lived on about a pound of coarse 
black bread and garlic, working for 10-18 hours a day. 
The fare of the peasantry has generally been black bread, 
milk, cucumbers, cabbage and other vegetables. Even in 
the towns, flesh was rarely eaten half a century ago. 

The French peasantry, till recently, fared chiefly on 
plant foods, and are said to have lived longer and in better 
health than those who now consume more animal food and 
stimulating drink. In many parts of France in 1875, the 
peasantry only ate flesh once or twice a year, and in Brit- 
tany not at all. 

The Italian peasants were wont to fare almost entirely 
on cakes and porridge of chestnut flour and wheat bread 
and Indian corn. They were a splendid, hardy people. 
The Italians in general live largely on maize, rice, vege- 
tables, macaroni, eggs and fruit. 

The food of the Spaniards for many generations con- 
sisted chiefly of coarse brown bread and grapes. 

The Egyptian peasantry has lived on coarse wheaten 
bread, Indian meal, lentils and vegetables, and they have 
been among the finest of people. 

The peasantry of Palestine have lived for the most part 



34 NUTRITION AND SPECIFIC THERAPY 

on bread dipped in oil, rice, olives, grape treacle, gourds 
and melons. 

The Greek boatmen were wont to live on rye or wheat 
bread, grapes, raisins and figs. 

In Poland the chief diet has been bread and potatoes, 
and the Poles have been noted for their endurance. 

The Arabs have lived chiefly on dates and milk. Their 
agility, endurance and strength are extraordinary. The 
rich classes have beef, goose and vegetables. 

Rice has been the commonest food of most of the hot 
countries of Asia. In the Northwest Provinces, unleav- 
ened bread made of wheat has been the staple food, and 
has produced a hardy population. 

The Chinese and Japanese peasantry who have lived on 
rice and vegetables with fish occasionally are about the 
strongest and most enduring workmen in the world. They 
use also pulses, fruits, roots and herbs. The rich classes 
include flesh. They do not use milk. (See end of Chap- 
ter VIII.) Soy bean cheese is a common food. 

The Jews have for thousands of years lived on a mixed 
diet, — bread, lentils, dairy products, beans, vegetables, 
honey, fruit and flesh. They have been a fairly strong 
race. 

The people of New England were accustomed to live 
on baked beans, potatoes, cod or mackerel. They were re- 
markable for physical and intellectual strength. 

In Mexico and Peru, maize and bananas have long been 
the staple food. 

The Chilian laborers have subsisted on figs, bread and 
beans. 

An interesting view of the diet recommended by Socra- 
tes is given in Plato's "Republic" : — 

They will live I suppose on barley and wheat, baking cakes 
of the meal, and kneading loaves, salt, olives, cheese, boiled 
onions and cabbage, — figs, peas, beans and myrtleberries and 
beech nuts roasted at the fire, and wine in moderation. And 



MEAT VERSUS VEGETARIAN DIET 35 

thus passing their days in tranquillity, they will, in all prob- 
ability, live to an advanced age. 

In these diets of nations, the fact is strikingly conspicu- 
ous that the great majority of the people have been vege- 
tarian, either in the strict sense or the less strict sense 
when dairy products have been included, and they have all 
been noted for strength and endurance. 

For untold centuries Buddhists and Brahmins have lived 
on a vegetarian diet. The old Greeks built their peerless 
empire on a meatless diet, and the armies of the Caesars 
achieved their military victories principally on wheat. 
Pythagoras, Plato and Plutarch were vegetarians, and in 
modern times, Jean Jacques Rousseau, the social philoso- 
pher, and Shelley, the poet. 

A high protein diet, which is synonymous with a meat 
diet combined with perhaps a quantity of dairy products 
and eggs, is undoubtedly responsible in whole or in part 
for many common diseases of to-day, — chronic rheuma- 
tism, kidney diseases, biliousness, pernicious anemia,, 
neurasthenia, intestinal catarrh, colitis, arteriosclerosis, 
diabetes and many others. 

Researches at the Pasteur Institute in Paris have indi- 
cated that animal protein decomposes twice as fast as vege- 
table protein in the intestines, and Bunge found that the 
toxins are four times as abundant in the intestines of flesh 
eaters as in those of persons living on a low, protein, vege- 
tarian diet. Other research men have confirmed this 
figure. 

A further argument in favor of a vegetarian diet is the 
fact that it is not subject to tuberculosis, anthrax, foot-and- 
mouth disease, septicemia, chicken cholera, tapeworm, 
trichinae and other parasites. 

Flesh foods as purchased are always in a state of putre- 
faction which is not destroyed by ordinary cooking, and 
bacteria enter the stomach where they often thrive in spite 



36 NUTRITION AND SPECIFIC THERAPY 

of the hydrochloric acid, and then enter the intestines. 
Here this cooked protein is a most favorable medium for 
the countless putrefactive bacteria already thriving there. 
Paratyphoid, Bacillus enteriditis, 2 and streptococcus in- 
fections have been produced many times through flesh 
foods, and the Bacillus botulinus has been responsible for 
many deaths. 

In the previous chapter the importance of lime was dis- 
cussed. Meats are almost wholly lacking in lime, for one 
pound contains only one-half grain, but a pound of peas 
contains eight grains, Man does not eat the blood and 
bones of the animal as do the flesh-eating beasts, and con- 
sequently does not get all the necessary elements of life. 
Man drains off the blood containing the valuable mineral 
matter, and throws away the bones. The result is a gen- 
erous supply of protein, potassium and extractives, or waste 
products, such as urea, uric acid and creatinine. 

The following tables by Bunge show to what extent cer- 
tain mineral matter is lacking in meat : — 

100 Grams Dried Substance Yields Milligrams Iron as 
Follows (Bunge) : 

Eggs 10.-21. Strawberries 8.6 

Milk 2.24 Blackberries 7.2 

Human milk 2.3 Baspberries 4. 

Spinach 33. Lentils 10. 

Asparagus 20. Peas 6.2-6.6 

Carrots 8.6 Almonds 10. 

Cabbage 4.5 Potatoes 6.4 

Outer leaves cabbage. 17. Wheat-flour 1.6 

Apples 13. Wheat 5.5 

Red cherries 10.6 Eye 5. 

Dates 2. Pearl barley 1.4 

Figs 3.9 Rice 1.-2. 

Pears 2. Beef 4. 

Grapes 6. 

All infants are born with a large amount of iron, which 
accounts for the above low figure. 
a M. J. Rosenau and H. Weiss, J. A. M. A., Dec, 1921. 



MEAT VERSUS VEGETARIAN DIET 37 

100 Grams Dried Substance Yields Milligrams Lime as 
Follows (Bunge) : 

Cow's milk 1423 Yolk of egg 380 

Human milk 243 White of egg- 130 

Strawberries 483 Graham bread 77 

Figs 400 White bread 46 

Dates 108 Butter 411 

Prunes 160 Potatoes 100 

Pears 95 Beef 24 

Iron of Common Fruits in Order of Per Cent. 



Strawberries 


Grapes 


Apples and clives 


Watermelon 


Prunes 


Figs 


Gooseberries 


Blueberries 
Cherries 


Peaches 



Calcium of Common Fruits in Order of Per Cent. 

Strawberries Olives Pears 

Watermelon Grapes Peaches 

Figs Cherries Blueberries 

Prunes Apples 

Iron of Common Vegetables in Order of Per Cent. 

Spinach Cabbage Cauliflower 

Lettuce Asparagus Carrots 

Radishes Onions Potatoes 

Calcium of Common Vegetables in Order of Per Cent. 

Spinach Radishes Carrots 

Cabbage Onions Cauliflower 

Lettuce Asparagus Potatoes 

Lentils have the highest per cent of iron of the legumes, 
— peas and beans have about one-half the amount of lentils. 

Beans have the most calcium, lentils contain a little less, 
and peas have the least. 

Iron of Cereals in Order of Per Cent. 

Barley Wheat and Rye 

Oats Corn and Rice 

Buckwheat 



38 NUTRITION AND SPECIFIC THERAPY 

Calcium of Cereals in Order of Per Cent. 



Oats 


Wheat 


Corn 


Buckwheat 


Rye 
Rice 


Barley 



Sodium, potassium and magnesium can be considered in 
this same way and the vegetables, fruits, cereals, legumes, 
roots and tubers will be found to be rich in all these ele- 
ments. 

Eggs and nuts also have a very large amount of all 
these mineral substances, but they should be relied upon 
for their protein and fat principally. The author recom- 
mends only a small amount of eggs. 

In the foregoing discussion it has been said that meats 
are laden with bacteria when purchased ; they are twice as 
putrefactive in the human intestines as vegetable protein ; 
they are many times laden with infectious diseases ; they 
are lacking in mineral matter; and because of their high 
protein content, a most favorable medium for bacteria in 
the colon, they produce numerous times many of our acute 
and chronic diseases. These diseases are further encour- 
aged on a high protein or meat diet for the reason that 
animal protein is too completely absorbed, inducing con- 
stipation. Man needs bulk and this he acquires by eating 
a certain quantity of cellulose each day. 

There must be some reason for the universal American 
malady, constipation, — and the answer is lack of cellulose 
and a high protein diet. The most stubborn case of consti- 
pation can, in all probability, be cured if the patient will 
live on a low protein diet with an adequate amount of 
cellulose derived from fruits and vegetables, combined 
with cereals, legumes, roots and tubers (with the skins) 
and a generous amount of water. 

The author is forced to conclude that a meat diet is 
against the laws for health for adults, and that it is par- 
ticularly wrong for young children as their immunizing 



MEAT VERSUS VEGETARIAN DIET 39 

organs have not been developed which aid in destroying 
the toxic substances produced by bacteria from meat in 
the intestines. Many authorities think the thyroid gland 
is the most important of these organs. These facts will 
be brought out clearly in the following chapter. 

The majority of people think a vegetarian diet very lim- 
ited. On the contrary, it stands for a diet of the greatest 
variety, as a greater variety of foods is desired when meat 
is not included. In this diet, cereals, legumes, nuts, or 
possibly eggs to supply the required protein, should be 
included each day. 

The author does not include milk to supply required 
protein, mineral substances and vitamines for adults, al- 
though most authorities favor it. In some cases it may be 
valuable for a limited time, for example, in certain irri- 
tations of the digestive tract in which the foods preferably 
recommended by the author are not tolerated because of 
certain idiosyncrasies. In other cases it is sometimes valu- 
able when a rapid gain in weight is desired, but milk as 
the sole article of diet should not be continued for too long 
a period in these cases, for it has been known to produce 
rheumatism and other infections because of too great a 
proportion of protein and putrefaction. 

Milk is dirty and bacteria laden by the time it reaches 
the consumer, even though certified ; it comes many times 
from diseased animals ; it gives too high a protein diet and 
too many bacterial toxins absorbed from the intestines if 
relied upon as the sole article of diet, so often recom- 
mended in digestive disturbances, or if taken with the 
average meal ; it is constipating because it is almost com- 
pletely absorbed; it is the food primarily adapted to the 
calf. 

Cheese has all the same objections as milk, plus the ob- 
jection that there are no cheese standards such as those 
required for milk. 



40 NUTRITION AND SPECIFIC THERAPY 

McCollum says: — 

Lacto-vegetarianism should not be confused with strict 
vegetarianism. The former is, when the diet is properly 
planned, the most highly satisfactory plan which can be 
adopted in the nutrition of man. The latter is fraught with 
grave danger unless the diet is planned by one who has exten- 
sive and exact knowledge of the special properties of the 
various food-stuffs employed. 

These statements are in perfect accord with the author's 
convictions, which favor the strict vegetarian diet only for 
those who possess this exact knowledge. When strict vege- 
tarianism is applied scientifically to the demands of the 
body, the reaction of the colon is acid, which has a decid- 
edly favorable influence upon health. (See Chapters IV, 

V > VL ) 

When a high protein diet is accused of being the cause 
of many diseases, the author does not include the acute 
and chronic infectious diseases in the same sense as that 
of the acute and chronic organic diseases, or possibly some 
deficiency diseases. Infectious diseases are caused by lack 
of specific antibodies (neutralizing and destroying sub- 
stances) in the blood and tissues, and deficiency diseases 
by lack of specific vitamines in the foods and perhaps also 
mineral substances, and by an "incomplete protein." The 
author is convinced that certain of these antibodies are 
lacking a great many times because of wrong diet, espe- 
cially a high animal protein diet lacking in mineral matter, 
and vitamines, but there is no conclusive laboratory proof 
of this fact. (See end of Chapter IV.) However, there 
is considerable laboratory proof that a high animal protein 
diet, or a diet insufficient for nitrogen equilibrium causes 
many acute and chronic organic diseases, — and that the 
lack of vitamines is either the sole cause or a contributing 
cause, combined with a high or too low protein diet, lack- 
ing in mineral matter, of deficiency diseases. 



MEAT VERSUS VEGETARIAN DIET 41 

In closing this chapter, it is only fair to enumerate the 
great objections that have been read relative to a vege- 
tarian diet: — 

1. Tendency toward poor utilization of the food prin- 
ciples. 

2. Blandness of such a diet, and lack of desirable stimu- 
lating qualities. 

3. Necessity of consuming a large volume of food to 
furnish the requisite nutriment. 

The author's answer is, — man's great aim should not be 
to absorb all he eats, — to keep the intestines free from 
harmful bacteria is fully as important; a vegetarian diet 
is not bland if one is not already overloaded with food, — 
on the contrary it is very stimulating if the person is 
hungry; man requires a large volume of food, — in other 
words a quantity of cellulose, to promote peristalsis and 
prevent the universal malady of constipation. 

The following statements have been repeated many 
times (Tibbies) : 

Vegetarians contend that their diet tends to health and 
longevity. But, it must be stated that the vegetarian is quite 
as liable to contract disease through his food or to suffer food 
poisoning as the flesh-eater. 

The vegetarian urges that meat causes diseases of the liver, 
gout, stone, gravel, chronic rheumatism, skin diseases, disturb- 
ances of the vascular system, arteriosclerosis, kidney disease, 
migraine and kindred ailments ; that ptomaine-poisoning may 
follow the consumption of meat; that the animal consumed 
may be the subject of anthrax, pneumonia, tuberculosis, glan- 
ders, various worms and other diseases, communicable to man. 
But quite as many examples can be produced against a veg- 
etarian diet. 

An excess of bread or other starchy food from the vegetable 
kingdom produces and promotes obesity, and sugar will pro- 
duce evils similar to those following an excess of starch; it 
especially causes catarrh of the stomach, attended by an 



42 NUTRITION AND SPECIFIC THERAPY 

abundant secretion of mucus. The ingestion of hard fruit, 
nuts and fibrous vegetables is a frequent cause of indigestion. 
The communicability of disease is by no means confined to 
flesh foods. The advice of medical practitioners in the tropics 
is, — "Eat no uncooked vegetables, or any raw fruit, unless 
you can pare it or peel it." Enteric fever, dysentery, cholera, 
diarrhea and various other diseases have often been traced to 
a disregard of such advice. Even in northerly and temperate 
climates the consumption of raw, unripe or over-ripe fruit is 
a frequent cause of diarrhea. Actinomycosis is due to the 
ray fungus which enters the organism with green vegetables, 
such as watercress, celery, lettuce, etc. Ergotism is a disease 
which commonly affects the consumers of rye-bread. In fact, 
the superior freedom of the vegetarian diet from disease-giv- 
ing properties vanishes entirely when the subject is carefully 
considered. 

These remarks seem to fail to present a fair argument. 
It goes without saying that an excess of bread, etc., or an 
excess for that matter of any kind of food is harmful. All 
thinking vegetarians admit commercial cane sugar is detri- 
mental to health. Indigestion is not caused from nuts, 
fruits and vegetables if properly masticated and eaten 
when ripe unless the person has a certain idiosyncrasy for 
these foods. The advice to avoid raw fruits and vegetables 
in the tropics is worthy of consideration because disease 
germs are much more abundant in these climates. How- 
ever, this objection is nothing against a vegetarian diet 
because fruits can be peeled and vegetables should be 
cooked when necessity demands this, and in this form they 
are far superior to meats and other animal foods in these 
hot climates where putrefaction in the intestines would be 
still more abundant on a meat diet, both because of the 
meat itself, and because of the sedentary life of the people 
in these climates. 

To complete this comparison of a meat diet with a vege- 
tarian diet, the average food composition of each of the 
principal groups of foods is given : — 



MEAT VERSUS VEGETARIAN DIET 



43 



Meats (Average Composition) 

Water 75.0 per cent. (Varies with the kind 

Protein 16.0 " " of meat and the cut.) 

Connective tissue 3.0 " 

Fat 4.5 " 

Mineral Matter 1.0 " 

Extractives 5 " 

Milk (Average Composition) 

Water 87.0 per cent. 

Protein 3.0 " " 

Fat 4.0 " " 

Carbohydrate 5.0 " " 

Mineral Matter 7 " " 



Cheese (Average Composition) 

Water 36.0 per cent. 

Protein 31.0 " " 

Fat 28.0 " " 

Mineral Matter 5.0 " " 



per 



Eggs (Average 

Water 73.7 

Protein 14.8 

Fat 10.5 

Carbohydrate 0.0 

Mineral Matter . . 1.0 



cent. 



Composition) 

The yolk is exceed- 
ingly rich in protein, 
fat and compounds of 
calcium, phosphorus 
and iron. The white is 
rich in protein, phos- 
phorus and calcium. A 
small amount of carbo- 
hydrate is also present. 

Dry Cereals (Average Composition) 

Water 10.0-12.0 per cent. 

Protein 10.0-12.0 

Fat 1.0-5.0 

Carbohydrates 65.0-75.0 

Mineral Matter 2.0- 3.0 

Cellulose 2.0 

The bran and the germ of cereals are removed in the 
milling, and the result is a great loss in mineral matter, 



44« NUTRITION AND SPECIFIC THERAPY 

protein and vitamines. These valuable substances are 
sold by the millers as feed for cattle, hogs and poultry. 
These animals, fed according to scientific rules, are not 
anemic and nervous. 

There are many advertisements of "entire wheat flour" 
in all the magazines and labelled as such on the packages. 
But if the people will read a little further in these adver- 
tisements, they probably will see in very small print, — 
"(with part of the bran removed). " There is very little 
whole wheat flour on the market that is entirely "whole," 
and people who wish this, and all the substances so valu- 
able for health will do well to send to some pure food store 
in one of the large cities or to some mill and have the 
flour sent direct to them. 

One of the best cereal foods known to the author is the 
whole grain wheat itself, washed and then boiled in slightly 
salted water for about forty-five minutes, and not drained. 
A little experience will accomplish this in the given time. 
Probably the majority of people would prefer this cereal 
cooked longer as it will not be very tender at the end of 
this period, but the merits of short periods of cooking 
have already been discussed. Whole grain wheat can be 
purchased at pure food stores and cooked as desired, or it 
can be purchased already cooked and canned. This is 
served with butter or cream, with or without sugar. 

Dry Legumes (Average Composition) 

Water 12 per cent. (The Soy Bean and 

Protein 21 " " Peanut excepted.) 

Fat 1.5" 

Carbohydrate 55 " 

Mineral Matter 2-5 " 

Cellulose 2-6 " 

It is interesting to compare the average composition of 
dried legumes and cereals, — their protein content being the 
important difference. 



MEAT VERSUS VEGETARIAN DIET 

Nuts (Average Composition) 



Water 



Protein 15-25 

Fat 50-70 

Carbohydrate 10 

Mineral Matter 2 

Cellulose 1-5 



45 



4- 5 per cent. 



Roots and tubers are primarily a carbohydrate food, 
although their mineral content is of great value. The 
following diagram compares their average food composi- 
tion with that of vegetables and fruits. 

Vegetables (Average Composition) 

p. c. 

Water 92.0 *\ 

^^^Protein ... r 1.0-^X 

Fruits — Same^_ Fat 5 *^- Same — Roots and Tubers 

Water 85. p. c.^\^ Carbohydrate ... 5.0 ^y Water 85. p. c. 

Carbohydrate. 5.-20. " ^Mineral Matter.. 1.0^/ Carbohydrate. 5.-20. " 

Cellulose 3. " Cellulose 1.0^ 



In other words, vegetables, fruits, roots and tubers are 
very similar in their protein, fat, mineral matter and 
cellulose content. Fruits, roots and tubers have less water 
and more carbohydrate than vegetables, and compare 
favorably with each other in their average composition of 
these two food principles, although the carbohydrate of 
roots and tubers is for the most part in the form of starch, 
while that of fruits is in the form of sugars. Fruits are 
higher in cellulose than vegetables, roots and tubers. 



CHAPTEE IV 

AUTO-INTOXICATION 

Auto-intoxication is a very inclusive term, and gen- 
erally misunderstood in its exact meaning. A great many 
people have heard and read of this so-called disease, but 
have never had sufficient interest to inquire into this very 
absorbing subject and study its causes, effects and bearing 
upon the general health of the body. It may be termed a 
disease in itself, or it may countless of times be the fore- 
runner of a great many of our common acute and chronic 
organic diseases, — and in the author's opinion it may also 
account for many infectious diseases, and be a contributing 
cause of deficiency diseases. It works like a thief in the 
night, slowly and surely poisoning the tissues, of every 
kind, and robbing them of their special functions. 

The term, auto-intoxication, is disliked by many of the 
medical profession, yet there must be some name to apply 
to the body when metabolic and bacterial products from 
the intestines accumulate in it which prevent the normal 
functioning of the body's organs. 

The chapters on cooked and uncooked foods, and on a 
meat versus a vegetarian diet have led up to this exceed- 
ingly important subject. 

In studying the literature on auto-intoxication, the defi- 
nition given by Professor Combe of the University of 
Lausanne, Switzerland, is in accordance with the author's 
convictions, and for this reason, a number of statements in 
his book are incorporated in this chapter. 1 

1 "Auto-intoxication." 

46 



AUTO-INTOXICATION 47 

This investigator says, — " Auto-intoxication is a toxemia 
caused by substances formed through the influence of the 
vital processes of the body/' and further states that it does 
not included infections or toxemias from tainted foods. 
According to his definition it is of two kinds, — from the 
functions of the tissues of the body and from the func- 
tions of the digestive canal. 

The first type is again divided into two classes, — those 
auto-intoxications produced by the tissues and those pro- 
duced by the antitoxic glands. Those produced by the 
tissues are the result of the metabolic decomposition of the 
living cells of the body, and are the normal products of 
the nutritive changes in the tissues. For example, — when 
the nucleins are destroyed into uric acid, purine bodies, 
xanthine, etc., and retained, uric acid diathesis of ar- 
thritis is the result. Secondly, when the albumins and 
fats are destroyed in too great quantity, the result is an 
accumulation of acetone and an acid intoxication. This 
type of auto-intoxication accompanies insufficient food, 
certain grave anemias, many intestinal affections and 
grave diabetes, — that is, it is observed whenever the fats 
and albumins of the body are destroyed in exaggerated 
proportions. The liver plays a very important role in con- 
nection with preventing this form of auto-intoxication by 
transforming, oxidizing and conjugating the harmful 
catabolic products into harmless ones which are for the 
most part excreted by the kidneys. It is claimed it reduces 
to one-fourth the toxicity of the poisons eliminated by the 
kidneys. 

The second type of auto-intoxication produced from the 
functions of the tissues is a toxemia produced by insuffi- 
ciency of the antitoxic glands ("immunizing glands"). 
These are divided into glands of external secretion and 
glands of internal secretion. To the first group belong 
the kidneys, liver, intestinal mucosa, respiratory tract, 
sweat glands and salivary glands. Consequently, when 



48 NUTRITION AND SPECIFIC THERAPY 

the kidneys do not function normally the result is uremia 
with an accumulation of toxic substances from the diges- 
tive canal and from the catabolism of the body tissues; 
when the liver is at fault the result is cholemia ; when the 
intestinal mucosa does not prevent toxic bodies from enter- 
ing the circulation, many grave results follow; when the 
respiratory tract, which eliminates carbonic acid, ammonia 
and perhaps acetone, and the sweat glands which elimi- 
nate small quantities of urea, ammonia, phenols, indol, 
and volatile fatty acids, and the salivary glands which at 
times may eliminate such substances as urea, do not per- 
form these functions, the result is an auto-intoxication 
from these glands of external secretion. 

To the second group belong the antitoxic glands of in- 
ternal secretion. These furnish the body with substances 
indispensable to health or they destroy by their antitoxic 
power substances noxious to the body. Whenever one of 
these glands does not function normally, toxic substances 
accumulate in the body. 

In this way tetany is produced from insufficiency of the 
parathyroid bodies, myxedema from insufficiency of the 
thyroid gland, acromegaly from insufficiency of the pitu- 
itary body, Addison's disease from insufficiency of the 
suprarenal capsules, diabetes from insufficiency of the 
pancreas, etc. These are the glands also that render sub- 
stances harmless which have been absorbed from the ali- 
mentary canal, and which have been produced as a result 
of the breaking down of the body cells. 

The second kind of auto-intoxication, according to 
Combe, is produced from the functions of the digestive 
canal, and is a toxemia caused by qualitative or quantita- 
tive alterations in normal digestion. In this is included 
the digestion by enzymes of the stomach, intestines and 
pancreas and also that by the bacteria which inhabit the 
digestive tract. 

The digestive enzymes convert starches into sugar, fats 



AUTO-INTOXICATION 49 

into fatty acids and glycerol, and proteins into amino- 
acids and ammonia. The bacteria do the same, but the 
action of the bacteria is not limited to producing these 
products. They carry the process farther and produce 
from these substances such products as hydrogen, carbonic 
acid, hydrogen sulphide, and methane; they produce irri- 
tating acids such as caproic, valeric, butyric, and propi- 
onic; they produce aromatic bodies such as indol, phenol 
and skatol, and ptomaines such as cadaverine and putre- 
scine. The above substances are not always harmful, but 
are when produced in quantities above normal, while cer- 
tain ptomaines are always harmful even in very small 
amounts (Armand Gautier). 

To elucidate the chemical changes that take place 
through this bacterial action, the following examples of 
its effect upon hydrolyzed and native food principles are 
given : — 

The putrefaction of tyrosine gives cresol and phenol 
(carbolic acid) ; the putrefaction of tryptophane gives 
skatol, indol and pyrrol; the fermentation of sugars and 
the putrefaction of fatty acids produce oxalic and butyric 
acids, carbonic acid, etc. ; the putrefaction of certain 
amino-acids, cystine for example, gives hydrogen sulphide, 
etc., and this gas is probably always harmful. The me- 
chanical action of carbon dioxide and hydrogen is gener- 
ally beneficial if not produced in too great quantities. 

Most of the phenol and indol enter the liver where oxi- 
dation and combination occur, and so they enter the circu- 
lation in a much less harmful form. In this way indican 
is produced, — this is present in all stagnations of the 
small intestines. It is not necessarily the result of con- 
stipation, although generally speaking, this condition is 
present. Sometimes indican indicates certain diseases, 
such as those of microbic suppuration. It is often found 
in anemia, tuberculosis and diabetes. 

One-tenth of the protein in our food may be said to be 



50 NUTRITION AND SPECIFIC THERAPY 

subject to bacterial decomposition. If a larger proportion 
than this is putrefied, the toxic substances produced by 
the bacteria increase beyond the control of the glands of 
external and internal secretion, and auto-intoxication is 
the result. 

The conclusion regarding the bacteria in the intestines 
is that they are useful when they carry digestion as far as 
the digestive enzymes, but that they are harmful when 
they transform the digestive tract into a laboratory of 
poisons. Protein putrefaction occurs almost entirely in 
the large intestines where the reaction is alkaline, and 
fermentation of carbohydrates in the small intestines. 
This fermentation makes the reaction of the small intes- 
tines acid in spite of the alkalinity of the digestive juices 
there. Sometimes both putrefaction and fermentation 
take place in the stomach. 

If one antitoxic or eliminating organ fails to perform 
its function, others may supplement it and auto-intoxica- 
tion may be delayed for a time. This condition, however, 
cannot continue indefinitely and the liver, kidneys and 
other organs, overstimulated as they have been, finally 
are forced into a condition of hypoactivity. At this point 
the toxins from the catabolism of the body tissues and from 
the digestive tract begin to accumulate and the result is a 
hyperproduction and a hypodestruction of toxins and the 
various acute and chronic organic and perhaps certain 
infectious diseases ensue. These may be various heart 
diseases, nervous diseases, glandular diseases, skin dis- 
eases, etc., according to the particular person in question. 
Often there is an effort on the part of the body to throw 
off these toxic substances through vomiting, diarrhea, 
bilious attacks and salivation. 

Every stomach that does not promptly digest its food 
is transformed into a laboratory of fermentation and putre- 
faction, and this condition is then produced in the small 



AUTO-INTOXICATION 51 

and finally in the large intestines, and many abnormal 
states of the body may result, — constipation, diarrhea, 
diseases of the intestines, appendicitis, dilatations, dys- 
pepsia, pyloric stenosis, flatulency, etc. To this list may 
be added headaches, fever, dizziness, tonsillitis, asthma, 
urticaria, diseases of the gums, diabetes, kidney diseases, 
arteriosclerosis, anemias, etc. 

When once the condition of auto-intoxication is estab- 
lished, what is offered in the way of treatment ? Accord- 
ing to many authorities, the antiputrefactive diet is a 
lacto-farinaceous diet (meat excluded). It has been 
proved there are four times as many toxins produced on a 
meat diet as on a lacto-farinaceous diet. But this is the 
same as saying that the replacing of meat with milk does 
not prevent putrefaction, but that it only reduces it. The 
pure culture sour milk preparations made with the Bulga- 
rian bacillus prove more beneficial than sweet milk in this 
diet, although the value of these milks has been overesti- 
mated. 

With the exclusion of meats and milk from the diet, 
the farinaceous foods are the only ones remaining on the 
list, with the exception of eggs, which should be classed 
with meat and milk, but which, in the author's opinion, 
do not seem to produce the harmful substances if eaten in 
small amounts. An added advantage is that eggs are 
sterile and not laden with bacteria like meat and milk. 
Although classed as protein foods, cereals, legumes and 
nuts may also be designated as farinaceous foods since they 
all contain starch. To these should be added the fari- 
naceous foods, — roots and tubers, and to a lesser degree 
the fruits and vegetables may be included as farinaceous 
or carbohydrate foods. 

The author's treatment consists in following the sixteen 
antitoxic rules for reforming the intestinal flora outlined 
in Chapter VI, giving special thought to maintaining 



52 NUTRITION AND SPECIFIC THERAPY 

nitrogen equilibrium on a protein diet little above the 
minimum, this depending upon the age, sex, climate, occu- 
pation and weight of the person. (See Chapter I.) 

Professor Combe gives the following treatment: — Di- 
minish nitrogenous putrefaction in the intestines so as to 
bring it back to normal if the antitoxic organs are com- 
petent. Bring nitrogen putrefaction to a point below nor- 
mal if the antitoxic organs are insufficient. Stimulate the 
antitoxic functions when they have become insufficient. 

All authorities admit that in convalescence and growth 
the protein ration must exceed considerably the minimum 
of nitrogen equilibrium. 

Many authorities do not advocate raw foods because 
they claim they are laden with bacteria. But repeated 
investigations have proved that sterile, vegetarian food 
modified the proportion of bacteria very little in the in- 
testines. (See Rule 15, Chapter VI.) 

Author's summary : Auto-intoxication may be a disease 
in itself caused by a temporary fermentation or putrefac- 
tion ; it may be the direct or secondary cause of acute and 
chronic, organic and deficiency diseases produced by wrong 
foods, which are the primary, indirect cause; it may be 
the indirect, secondary cause of some infectious diseases, 
the lack of antibodies being the tertiary cause, and the 
bacteria, themselves, the direct cause. In other words, it 
is caused by too much or too little wrongly prepared and 
combined foods, or wrong foods, deficient in mineral mat- 
ter and vitamines, which stagnate, ferment and putrefy in 
the alimentary canal, and these toxic products are absorbed 
which cause the eliminative organs and antitoxic glands 
to become overstimulated and finally worked into a state 
of hypoactivity. Vitamines and mineral matter are lack- 
ing which are necessary for metabolism, the vitamines per- 
haps being necessary for the fixation or functioning of the 
mineral matter. Coincident with this condition the body's 
metabolism is wholly deranged and the products of catab- 



AUTO-INTOXICATION 53 

olism are not eliminated, and accumulate, and finally are 
expelled through various channels. In the meantime the 
many acute and chronic organic, and possibly some infec- 
tious and deficiency diseases may have made their inroads. 

The production of indol in the colon from tryptophane 
by bacterial putrefaction and its transformation into indi- 
can by the liver in which form it is rendered comparatively 
harmless and as such is excreted in the urine, has long 
been known. 

The advocates of a low protein, vegetarian or lacto- 
vegetarian diet, are daily confronted with the following 
question : — Why is it that in the case of two persons living 
under the same conditions and eating the same food, say 
a high protein meat diet, one is perfectly well while the 
other has many symptoms of auto-intoxication, such as, 
neurasthenia, muscular exhaustion, constipation or dia- 
betes? The answer may be found in the fact that there 
may be the same amount of indol and other poisons formed 
in the intestines of these two persons, but in the case of 
one, the lining of the intestines does not permit the poi- 
sons, for some reason, to pass through into the blood, while 
in the case of the other, the lining does not act as a defen- 
sive agent, and these poisons are allowed to pass through. 
In the first case, therefore, it would be expected that there 
would be a considerable quantity of these poisons in the 
feces and very little in the urine. In the other case 1 , con- 
ditions should naturally be the opposite. Again in these 
two persons, the epithelial lining of the intestines may 
act to a very slight degree as a protection against putre- 
factive poisons and consequently large quantities may be 
carried to the liver from the intestines. Here, however, 
there may be a difference in the protective power of the 
liver in these two persons. In the healthy person these 
poisons may be conjugated, oxidized and otherwise trans- 
formed into harmless substances such as the conjugation 
of indol with potassium and sulphur which is indican ; in 



54 NUTRITION AND SPECIFIC THERAPY 

the sickly person the liver may not readily perform these 
functions. Innumerable such reasons might be cited as an 
explanation of the many times asked query. The answer 
to this mystery may be found in temporary impaired 
functioning of the sympathetic nervous system through 
causes other than diet. As a result, indican and other 
poisonous substances in the urine are not always a sign 
of auto-intoxication. But generally an analysis of the 
poisonous and waste products of the urine is significantly 
indicative. 

To illustrate the effect of meat poisons absorbed from 
the intestines, the following experiment was demonstrated 
at the laboratory of Professor Pawlow : — A dog with Eck's 
fistula (the portal vein, which carries the toxin laden 
blood to the liver to be rendered harmless, was attached 
to the vena cava), recovered in a few days on a vegetarian 
diet; but when it was fed on a meat diet, the dog died 
within three days because the toxins from the meat were 
carried into the general circulation without being rendered 
harmless by the liver. A dog has a liver four times as 
large as a man's in proportion to his size. A dog for this 
reason can thrive on a meat diet far better than man. 

All literature seems to point to the increase of diabetes, 
kidney diseases, appendicitis, neuritis, rheumatism, dis- 
eased tonsils, pyorrhea, etc. Surely there is some power- 
ful cause which produces these pathological conditions, 
and it is the author's conviction that this cause can be con- 
trolled if educators will make it a part of required educa- 
tion to teach enough of the subjects outlined in the begin- 
ning of this book to enlighten people about the functions 
of their own bodies. How many people are as well versed 
in the physiology and requirements of their own bodies as 
they are in the different arts, — and the innumerable other 
studies and subjects that occupy all their thinking hours? 

There is an old saying, — "Most men dig their graves 
with their teeth," and another one says, — "The science of 



AUTO-INTOXICATION 55 

living begins at the mouth." Never were two statements 
more true. 

A very common symptom of auto-intoxication is indic- 
anuria in children. These children are irritable and diffi- 
cult to control, and extremely fickle in their appetites. 
Their circulation is often at fault, and they are constantly 
taking cold. Their susceptibility to tonsil infections may 
be due to this cause. Their sleep is perturbed. 

These children do not appear exactly ill, and a physician 
is therefore seldom consulted. So these cases drift along, 
restless, anemic, and unhappy. By the time adult life is 
reached, there are pronounced, abnormal symptoms of per- 
haps the heart, the kidneys, the appendix, the bladder, the 
pancreas, etc. These unwary sufferers begin to think and 
question and wonder how and why their bodies' functions 
have become disturbed, — and the majority never are en- 
lightened, or understand, but try many useless cures from 
that time on till death finally claims these unfortunate vic- 
tims of auto-intoxication. 

Paul E. Cannon 2 says after eliminating cases of chronic 
infections in the digestive tract or elsewhere and those 
which have been shown to be the result of nervous reflexes, 
"there are still many instances of acute and chronic condi- 
tions in man in which no fecal infections have been found, 
and in which there is definite evidence of an intoxication 
of intestinal origin." He states there is a contrast in the 
tendency of animal and vegetable proteins to encourage 
putrefaction in the intestinal tract. "Torrey pointed out 
this peculiarity when he found that vegetable proteins do 
not offer the slightest encouragement to the growth of the 
intestinal putrefaction types of bacteria. My experiments 
agree with those of Torrey in that vegetable proteins not 
only reduced the relative proportion of proteolytic types, 
both aerobic and anaerobic, but also encouraged the over- 
growth of a nongas-producing aciduric flora ; animal pro- 

2 J. Infect. Dis., Oct., 1921. 



56 NUTRITION AND SPECIFIC THERAPY 

teins on the other hand, such as meat, fish and eggs, led to 
an enormous overgrowth of gas-forming proteolytic types." 

Underhill and Simpson 3 have found that the diets 
which give rise to the excretion of phenol and indican in 
large quantities are the ones that lead to the overgrowth 
of putrefactive bacteria in the intestines. Meat led to a 
marked increase of phenols and indican, whereas casein 
caused much less phenol and indican. These research 
men found vegetable proteins to produce the same amount 
as casein, but the experiments of Cannon and Torrey, ac- 
cording to the above statement, do not confirm these results. 

In connection with the author's convictions that auto- 
intoxication may be caused by deficiencies in the diet, 
which may be a contributing cause of infectious diseases, 
the following researches by S. S. Zilva 4 are of interest and 
point to a broad field of research in this subject. He states 
that besides the radical changes produced by deficient nu- 
trition already recorded, it is quite possible that decided 
modifications may take place in the body tissues and fluids 
which are not discernible macroscopically or microscopi- 
cally, but which may nevertheless restrict physiologically 
the functions of the organism. In this connection arises 
the interesting problem whether the resistance to disease 
of the animal is in any way influenced by deficient nutri- 
tion. (See Pernicious Anemia.) 

Zilva carried out experiments with deficient diets on 
amboceptor and agglutinin formation and the complement 
content, but says that owing to the complexity of the sub- 
ject, the experiments can be considered only of a prelimi- 
nary character. The results obtained, although of an un- 
expected nature, are nevertheless of general interest, and 
suggest the necessity of future investigations. Rats and 
guinea pigs were used in these experiments. 

The influence of the following dietetic deficiencies on 

3 J. Biol. Chem., Oct., 1920. 
'Biochem. J,, May, 1919. 



AUTO-INTOXTCATION 57 

the production of these antibodies (neutralizing and de- 
stroying substances) was studied. 

1. Deficiency of calcium, iron, potassium, dhlorine, 
phosphorus. 

2. Deficiency of certain amino-acids. 

3. Deficiency of the three vitamines. 

Only the group which received a diet deficient in phos- 
phorus showed a decidedly poorer response to the inocu- 
lations in the production of amboceptor and agglutinins. 
Growth was restricted in these experiments. 

In conclusion, he states that a systematic study of the 
influence of nutrition on the production of immunity, al- 
though complex and laborious, is urgently called for, and 
may not only prove to be of direct clinical value, but may 
elucidate many obscure points in the complicated mech- 
anism of immunity. 



CHAPTEE V 

BACTERIOLOGY OF THE DIGESTIVE TRACT 

In the preceding chapter, the author's conviction is 
stated that certain bacteria of the alimentary tract are the 
principal cause of auto-intoxication, which in turn may be 
the cause or a contributing cause of organic, infectious, 
or deficiency diseases. Bacteria in this region are always 
present, and harmful, with a few exceptions, when carry- 
ing digestion farther than the enzymes. 

According to F. P. Underhill and G. E. Simpson "the 
pioneer work of Herter and Kendall, and more recently of 
Eettger and his coworkers, and of Torrey shows that diet 
is effective in regulating the character of the intestinal 
flora." The author is indebted to Professor Herter 1 for 
some points of interest concerning the characteristic in- 
testinal flora of childhood and adult age. 

Because the digestive tract is extremely abundant with 
bacterial forms, many research men in this subject have 
endeavored to solve the meaning of this fact. There are 
some animals of the arctic regions such as polar bears, 
seals, reindeer and ducks that have no bacteria in their 
digestive tracts. 

Many experiments have been carried on to determine 
whether bacterial life in the intestines is essential to de- 
velopment, — some investigators have said yes, while others 
have said no. But the fact remains that in the tropical 
and temperate climates it is impossible to avoid the en- 

1 "Bacterial Infections of the Digestive Tract." 

58 



BACTERIOLOGY OF THE DIGESTIVE TRACT 59 

trance of bacteria into the digestive tract. Some forms 
seem to have a beneficial effect, such as those that produce 
lactic acid, while others are pronouncedly harmful. But 
the normal body is provided with more or less efficient 
methods of defense against the harmful bacteria; the 
acidity of the gastric juice destroys them; the pepsin of 
the stomach, the trypsin of the intestines, and other en- 
zymes digest many of these bacteria ; the intestinal mucosa 
prohibits the passage of many bacteria into the tissues ; the 
liver destroys many others that do escape through the in- 
testinal lining; the spleen destroys others through its pro- 
duction of antibodies, — and other defenses exist which are 
not so well understood. 

These bacteria may be classified into three groups, — the 
aerobes, the anaerobes and the facultative anaerobes. The 
aerobes are those bacteria which require free oxygen for 
their development ; the anaerobes thrive where there is no 
free oxygen ; the facultative anaerobes multiply best in the 
presence of free oxygen, but can also increase under the 
same conditions as the anaerobes. 

The aerobes are the bacteria found in the normal colon 
and are antagonistic to the anaerobes, because of certain 
acids which they produce, — especially lactic acid. Many 
facultative anaerobes are also present in the normal, 
healthy colon. The strict anaerobes are those that charac- 
terize the colon of auto-intoxication where the medium is 
alkaline, and not acid as in the healthy colon. They, in 
other words, are those that produce putrefaction. 

Bacteria, like all living things, require nitrogen for 
their development. Therefore, protein and protein deriva- 
tives are utilized by bacteria for their growth and energy, 
and carbohydrates and fats are also a source of energy. 

These bacteria can be absolutely regulated by the diet 
chosen in any particular locality. The character of the 
food, its solubility and its volume, together with the com- 
position of the digestive juices, determine the bacteria of 



60 NUTRITION AND SPECIFIC THERAPY 

the digestive tract. Roger has said there are about 160 
varieties in the alimentary canal. 

First Bouchard, then Roger, Metchnikoff, Tissier and 
others took up the subject of these bacteria. 

While bacteria are always present" in the digestive tract, 
yet they are not always the same at all times of life. 
Professor Distaso, assistant to Metchnikoff, at the Pasteur 
Institute, Paris, in an exhaustive research in relation to 
the intestinal bacteria, found the following to be true, 
which also confirmed work done by Professor Tissier, also 
of the Pasteur Institute : — Within a few hours after birth 
a protective germ, the Bacillus bifidus is found in the 
intestines. So long as the reign of this germ lasts, the 
infant remains in a healthy condition. But when the in- 
testines become infected with the Bacillus coli and others 
through cow's milk during the nursing period, and later 
through the many other foods given a young child such as 
meat broths, meats, eggs, etc., these delicate bifidus germs 
are driven out, and the way prepared for the development 
of the putrefactive bacteria. These are the bacteria that 
are responsible for the majority of the ills of infancy, 
childhood and adult age. The bifidus germs that are not 
destroyed aid in stimulating the colon and preventing 
constipation. 

In nurslings the bacteria of the intestines are very 
simple. A few examples are the Bacillus bifidus of Tis- 
sier, the Bacillus lactis aerogenes, and the Bacillus acid- 
ophilus. There are a few of the Bacillus coli and Bacil- 
lus aerogenes capsulatus, also called Bacillus welchii 
Bacillus perfringens, the gas bacillus, and other names. 

Bottle-fed children have a great number of bacteria even 
when the milk has been pasteurized or sterilized. The 
number of bacteria in raw cow's milk ranges from 1000- 
2000 per c.c. in certified milk, to several million per c.c. 
in uncertified milk. Ordinary cow's milk contains 100,000 
per c.c. 



BACTERIOLOGY OF THE DIGESTIVE TRACT 61 

There is, therefore, a striking difference between the 
bacteria of the intestines of nurslings and the bacteria of 
the intestines of infants fed on cow's milk, for in the case 
of the latter there are many more of the Bacillus coli and 
many less of the Bacillus bifidus. There are numerous 
others such as diplococci, the Streptococcus lacticus, cer- 
tain staphylococci, the Bacillus aerogenes capsulatus, the 
Bacillus proteus vulgaris which forms indol and skatol 
from casein, the Bacillus putrificus, etc. Streptococci are 
known to produce severe cases of ileocolitis in infants and 
children. 

According to Paul Heinemann, there are two kinds of 
streptococci in market cow's milk. The one that produces 
intestinal disturbances and septic sore throat is the patho- 
genic, fecal and sewage streptococcus; the other is the 
Streptococcus lacticus which is the ordinary bacterium 
which cooperates with the Bacillus aerogenes lacticus in 
producing lactic acid in milk. 

In other words, the lactic and succinic acid forming 
bacteria (beneficial bacteria) become less and less numer- 
ous and the putrefying bacteria become more and more 
numerous as age advances, according to the food ingested, 
or in other words, the aerobes decrease and the anaerobes 
and facultative anaerobes increase. 

It is found there is a great difference between the num- 
ber of anaerobes in the intestines of adults on a meat diet 
as compared with the number on a vegetarian diet. The 
anaerobes are diminished by two-thirds in the presence 
of large quantities of carbohydrate and cellulose. The 
conclusion is evident, namely, that a vegetarian diet pro- 
duces acid forming bacteria in the intestines which prevent 
putrefaction. 

In view of this fact, it is interesting to cite some im- 
portant facts concerning the Bacillus coli, so universally 
present and commonly discussed. 

In the first place its action can be controlled by the diet 



62 NUTRITION AND SPECIFIC THERAPY 

chosen, — it can be rendered either beneficial or harmful, 
or it may be said that the diet can be so regulated as to 
force the Bacillus coli either to produce fermentation or 
putrefaction. Secondly, this bacillus cannot hydrolyze 
native protein (the proteins as found in unchanged foods), 
but the Bacillus aerogenes capsulatus and other anaerobes, 
especially Bacillus putrificus, can hydrolyze native pro- 
teins. On a meat diet, there are many of the Bacillus 
aerogenes capsulatus and similar bacteria present, and a 
great deal of unabsorbed cooked, partly digested protein 
reaches the large intestines. These anaerobes then hydro- 
lyze the proteins that escaped absorption, and being very 
numerous, they also attack any fats and sugars that 
escaped absorption. There are quantities of prepared food 
for the Bacillus coli, in the case of a high protein diet, 
from which to produce toxic substances, and other facul- 
tative anaerobes together with the strict anaerobes add to 
these toxic products, Examples of such substances are 
butyric acid, hydrogen sulphide,, phenol, skatol, indol, 
putrescine and cadaverine. Thus the Bacillus coli is forced 
to produce quantities of indol on a meat diet or a high 
protein diet. 

There is, therefore, the greatest necessity for a low pro- 
tein diet and for prompt absorption, when practically no 
unabsorbed protein reaches the colon. Under these con- 
ditions the anaerobes cannot thrive and the Bacillus coli 
and others of this class are compelled to produce fermen- 
tation because of the great quantity of carbohydrate pres- 
ent, especially if much of the food has been eaten in the 
raw state in the form of salads, fresh fruits, figs, dates, 
prunes and raisins, and nuts, or if it has been cooked for 
only a short period. The reason for this is that a con- 
siderable quantity of carbohydrates escapes absorption 
through increased peristalsis, and consequently reaches the 
colon where the Bacillus coli flourishes. 



BACTERIOLOGY OF THE DIGESTIVE TRACT 63 

Much has been written about the Bacillus coli in rela- 
tion to its producing deadly poisons which give rise to 
degeneration of the liver, kidneys, blood-vessels, nerves, 
etc., and as has been said, these poisons are produced 
mainly from animal protein; whereas in the presence of 
an abundance of carbohydrates and cellulose, the colon 
germ produces harmless acids instead of deadly poisons. 

In an article published by Dr. Robert Morris, the fol- 
lowing statements have been made: — The Bacillus coli 
probably stands next to the tubercle bacillus in the pro- 
portion of deaths which it causes. Dr. Morris charges this 
bacillus with being the cause of diseases of the appendix 
and inflammation in the region of the pylorus and duo- 
denum and many cases of gastric disturbances. It is said 
sometimes to cause gall-stones, and that diabetes may be 
the result of an inflammation of the pancreas set up by 
the colon bacillus. It is also said that hardening of the 
liver and arteries may be caused by it more than by 
syphilis or alcohol, and that it may prepare the way for 
infantile paralysis, and may cause many cases of neu- 
rasthenia. In scarlet fever, diphtheria, measles, typhoid 
fever and other infectious diseases, this bacillus is often 
the only one found in the urine. Cases in which patients 
have suffered from albumin in the urine have been cured 
by the removal of an inflamed appendix from which the 
colon bacillus entered the circulation. 

The author's conclusion is that in these infections the 
toxins produced on a high protein diet, lacking in mineral 
matter, may have interfered with the production of anti- 
bodies for combating these particular infectious diseases. 

Professor Herter has made numerous experiments for 
the purpose of determining the effects of indol (formed 
from the amino-acid tryptophane) upon the body produced 
by the colon bacillus and other bacteria under anaerobic 
conditions, and has found that this poison produces head- 



64 NUTRITION AND SPECIFIC THERAPY 

ache, insomnia, irritability, coated tongue, sallow com- 
plexion, dullness of niind, cold hands and feet and a score 
of other symptoms. 

Professor Herter gives the following types of chronic 
excessive putrefaction : — 

1. Indolic. 

2. Saccharo-Butyric. 

3. Combination of the two. 

In the first the Bacillus coli may invade the small in- 
testine and produce indol there as well as in the large 
intestine. In the second type the Bacillus aerogenes cap- 
sulatus is the most prominent. This bacillus thrives on 
carbohydrate as well as protein and produces much butyric 
acid and gas. This type of putrefaction is widespread 
among adults, and it is claimed there are few people who 
do not suffer from it from time to time. They experience 
great muscular and mental fatigue, mental depression and 
emotional irritability. Ammonium butyrate is formed in 
large quantities which is very irritating, often producing 
diarrhea and irritation of the entire digestive tract. 

There seems to be little doubt that in time these types 
of putrefaction will lead to many of the common afflictions 
of man, — colitis, appendicitis, kidney diseases, acidosis, 
rheumatism, neuritis, etc., and that they will prepare the 
way for many other types of diseases. 



CHAPTER VI 

REFORMING THE INTESTINAL FLORA 

Having considered the different types of bacteria that 
are ever present and thrive in the intestinal tract and the 
effects produced by them, the next question of interest 
is to determine how best to regulate their growth which 
has so great a determining influence upon health. 

From the foregoing chapter, it is fully evident that the 
diet should be so regulated that the acid forming bacteria 
predominate. All scientific men interested in the subject 
of diet agree on the beneficial effects of lactic acid in the 
large intestines, a fact first popularized by Metchnikoff. 
Every reader has doubtless read or heard much on the 
subject of conveying to, or producing in the large intes- 
tines, lactic acid which, as has been said, antagonizes 
anaerobes and combats putrefaction. Much literature has 
been written concerning the consumption of large quan- 
tities of buttermilk, kumiss, kefir, etc. 

It is the author's opinion that the value of these foods 
containing lactic acid or lactic acid forming bacteria has 
been greatly overestimated. When lactic acid is taken 
directly in the food, it is generally completely absorbed 
before it reaches the colon, and if the bacteria themselves 
are ingested, they are in all probability killed or digested 
before they reach the large intestines. Pure culture lactic 
acid milks very probably hasten digestion in the stomach 
because the clot formed by the rennin is smaller and not 
so tough ; they also may favor peristalsis in the small in- 
testines and consequently in the large intestines, — these 
two reasons may speak favorably for the lactic acid prepa- 

65 ° 



66 NUTRITION AND SPECIFIC THERAPY 

rations, but they do not confirm the hopes that the acid 
itself or the bacteria ever reach the colon. For those who 
wish to prepare buttermilk for the above reasons, the 
Yogurt tablets may give a certain amount of satisfaction. 

The best known of the beneficient germs or aerobes is 
the Bacillus bulgaricus discovered by Grigoroff. This 
germ produces lactic acid from glucose and consequently 
this bacillus has been put up in tablet form to be eaten as 
such three times a day or used for producing buttermilk, 
in the hopes of flooding the colon with lactic acid to combat 
putrefaction. But the fact that sugar is generally com- 
pletely absorbed before it reaches the colon gives the Ba- 
cillus bulgaricus a very poor chance to develop in the 
colon, even if it escaped the effect of the hydrochloric 
acid, and later, digestion in the small intestines, especially 
on a meat diet in which the carbohydrate ration is low. 
By what scheme then can the Bacillus bulgaricus and 
similar bacteria be developed in the colon? The answer 
would seem to suggest itself in the light of what has been 
written in the previous chapters. On a vegetarian diet, 
and especially a raw diet, some of the starch and sugar 
necessarily would seem to escape absorption in the small 
intestines and would reach the colon. There the bacteria, 
that hydrolyze starch to sugar, and oxidize the sugar to 
lactic acid are in the majority, and the perplexing prob- 
lem would seem to be solved. In other words, the author's 
conclusion is that the most efficient method whereby to 
obtain lactic acid in the colon is not through eating these 
tablets or drinking lactic acid preparations, but by living 
on a low protein diet (so-called vegetarian diet), with a 
generous supply of salads and fruits, for under these con- 
ditions the aerobes that normally thrive in the colon will 
be forced to produce the much desired lactic acid. 

To show the preservative effects of lactic acid, an inter- 
ested experimenter immersed a piece of beefsteak in but- 
termilk made from a culture of the Bacillus bulgaricus, 



REFORMING THE INTESTINAL FLORA 67 

and kept it in a state of preservation for several years. 
If this is true, the fact is clearly demonstrated that lactic 
acid antagonizes anaerobes and prevents putrefaction. 

With these facts in mind, the following rules for en- 
couraging the growth of aerobes will prove helpful : — 

Sixteen Rules for Reforming the Intestinal Flora. — 
1. To reform the intestinal flora completely, all animal 
protein must be excluded for the time being, which in- 
cludes meats and fish of all kinds, and also milk, cheese 
and eggs. In extreme cases of putrefaction and auto- 
intoxication this is absolutely necessary (tests for C0 2 in 
the blood, and indican, uric acid and urea in the urine are 
indicative). In milder cases some eggs may be allowed. 

The most efficient procedure for completely reforming 
the intestinal flora would be to withhold all food for 24 
hours, giving nothing but water and possibly a cathartic 
of Pluto water. At the end of this period, give only fresh 
fruit juices for 24 hours. Then gradually increase the 
diet according to the rules enumerated. 

2. The diet should consist of unrefined cereals, legumes 
(cooked no longer than is absolutely necessary), nuts and 
possibly some eggs (in other words, the four most ideal 
protein foods according to the author). Nuts should be 
eaten as the principal protein food of the meal and not 
at the end of the meal as a side dish. Combine these four 
protein foods with a generous supply of roots and tubers, 
fresh vegetables and fruits. The cereals should be unre- 
fined except in cases of an irritated digestive tract, and 
should never be drained after cooking. The roots and 
tubers should be eaten with the skins if possible, because 
of their protein, mineral matter, vitamine and cellulose 
content. 

Prunes, figs, dates and raisins are excellent fruits if 
purchased in a sanitary condition. Honey is an excellent 
food. 

3. Drink several pints of water a day. 



68 NUTRITION AND SPECIFIC THERAPY 

4. Take some kind of physical exercise. 

5. Do not overeat. This is best accomplished by omit- 
ting animal foods. 

Never eat merely because it is meal time. Appetite and 
hunger should not be confused. There is an old saying, — 

"Three meals for animals, two for man and one for 
angels." 

There are many people who live on two meals a day, 
especially during the summer months. The author rec- 
ommends two meals a day the year round for many brain 
workers. 

A person should not eat too often. Those so-called 
pangs of hunger without reason in the middle of the fore- 
noon or afternoon do not denote hunger. They are prob- 
ably due to customary reactions of the stomach formed 
through the habit of eating between meals. A person 
who has formed this habit should realize that "a single 
caramel or nougatine may furnish sufficient energy to sup- 
ply the extra heat needed to walk a mile." 1 Another cal- 
culation says that "one-half doughnut or six walnuts give 
enough Calories (80) to walk from the bottom to the top 
of Washington Monument. 1 Perhaps it can be learned 
from this how futile a constitutional walk is in any at- 
tempt to combat the accumulating energy from undue eat- 
ing between meals." 

6. Do not eat too little. Nitrogen equilibrium must 
be maintained, sufficient carbohydrate and fat must be 
eaten to produce the required amount of heat and energy, 
there must be a balanced mineral ration for all the tissues 
and body secretions, a sufficient quantity of cellulose to 
promote normal peristalsis and an adequate supply of 
vitamines for health. 

7. Habitual use of tea and coffee should be prohibited 
as far as possible. The tannin interferes with digestion 
and the caffeine paralyzes the sympathetic nerves of the 

l'C. G. Benedict, F. G. Benedict, Boston M. and S. J., Oct., 1919. 



REFORMING THE INTESTINAL FLORA 69 

intestines, and aids in causing arteriosclerosis. They often 
produce gastric catarrh, nausea, headache and other 
symptoms. 

8. Tobacco and alcohol produce many pathological 
conditions, — gastric catarrh, dyspepsia, irritation of the 
mucous membranes, irregular heart action, defects of 
vision, arteriosclerosis, etc. 

9. Condiments should be prohibited, — horseradish, 
mustard, pepper and spices. All are generally constipat- 
ing and irritating to the digestive tract, liver, blood-vessels 
and kidneys. 

10. Vegetable fats should be chosen in preference to 
animal fats, which are more difficult to digest and more 
easily putrefied. Nuts with their 50 per cent fat, olive 
oil, etc., and soy beans (18 per cent fat) are excellent. 

11. Cane sugar should be eaten in very small quan- 
tities. Large amounts (100 grams) give rise to gastric 
catarrh, and produce oxalic acid which in large quantities 
gives rise to oxaluria. The symptoms of this condition 
are dyspepsia, nervous exhaustion, and mental distress. 
It also produces alcoholic fermentation, gas and the irri- 
tating butyric acid. Calcium in the body very readily 
combines with oxalic acid, forming calcium oxalate, which 
appears as "gravel" in the urine. As a result, the body 
is robbed of its necessary calcium. In this connection it 
is interesting to read that in 1598 Heutzer, a German 
traveller, thus describes Queen Elizabeth, then 65 years 
old, — "Her nose is a little hooked, her lips narrow and 
her teeth black, a defect the English seem subject to from 
their great use of sugar." 

Commercial cane sugar is probably the most concen- 
trated, artificial food product on the market, for the sugar 
cane juice is bleached, neutralized, coagulated, filtered, 
centrifuged, clarified and evaporated in vacuo, — and the 
American citizen is reported to average one-fourth pound 



70 NUTRITION AND SPECIFIC THERAPY 

a day of this artificial product, which depresses gastric 
secretion. 2 

Cane sugar is wholesome in small amounts as found in 
all fruits and some vegetables, roots and tubers, cereals 
and legumes. But the sugars to which the stomach and 
intestines are adapted in larger quantities are milk sugar, 
malt sugar (produced by the action of the ptyalin of the 
saliva on starch, and also by the pancreatic enzyme, 
amylopsin in the small intestines) and dextrose and levu- 
lose. Beet sugar and maple sugar are chemically indis- 
tinguishable from the product of the sugar cane. 

A word here may be added in favor of a small amount 
of unbleached molasses, which is the residue from the re- 
fining of the juice of the sugar cane. Sorghum, so exten- 
sively grown in this country, is made from the African 
millet, and is a wholesome food if unbleached with sul- 
phur compounds. 

12. Avoid iced drinks and very hot drinks. Iced 
drinks chill the stomach and retard digestion. The 
stomach has few sensory nerves and consequently does not 
react against the hot liquids so frequently poured into it 
that in reality have almost burned the mouth. 

A very safe rule is to drink before or at the end of a 
meal, or drink in small quantities with a meal, water that 
is neither ice cold nor very hot. Drinking with meals as 
a rule causes one to drink too much, and this may result 
in dilatation of the stomach, or it may cause the food to 
be swallowed in lumps and consequently digestion is de- 
layed in the stomach and bacterial fermentation and putre- 
faction result. Sipping small amounts of water with 
meals may prove beneficial by stimulating the flow of 
gastric juice. A. C. Ivy 3 says: — "The ingestion of water 
with the meals (400-800 c.c.) increases the amount, and 
the free and total acidity of the gastric juice. The inges- 

2 A. J. Physiol, Aug., 1920. 
8 A. J. Physiol, April, 1918. 



* REFORMING THE INTESTINAL FLORA 71 

tion of water with the meals decreases the emptying time 
of the stomach, due to the dilution of the stomach con- 
tents." 

13. Avoid fresh breads and pastries of all kinds. They 
are prone to produce fermentation and putrefaction in 
the stomach and intestines. 

14. Avoid complicated menus for reasons previously 
stated. 

15. Wash all fresh fruits and vegetables very thor- 
oughly before serving them raw. (The Bacillus putrificus 
is often on the surface.) 

16. Avoid cathartics except in cases of emergency. 
They do not decrease the intestinal putrefaction when 
habitually used, except as they stimulate peristalsis and 
force a mechanical voiding of the anaerobes. The reduc- 
tion in these bacteria is merely transient, and is followed 
by the usual putrefactive bacterial development. 

With these rules in mind, a pint of water drunk at night 
and the use of a certain amount of sterilized bran each 
morning will probably combat the most stubborn case of 
constipation. ( See Cathartics, Chapter X. ) 

These sixteen rules signalize unretarded digestion and 
prompt absorption. In other words, these are the rules 
for reforming the intestinal putrefactive regime, and for 
combating constipation, and the resulting numerous dis- 
eases. Peristalsis may be stimulated to such a degree that 
there are two movements a day, but this is a result to be 
desired rather than one to cause worry. 

Referring to Rule 7, the chemical composition of tea, 
coffee and chocolate is given on pages 72 and 73. 

The amount of caffeine in the two kinds of tea does not 
materially differ, but the percentage of tannic acid shows 
a much larger proportion in green tea. This fact is ac- 
counted for by the process of fermentation to which the 
black tea is subjected which renders a portion of the tannic 
acid insoluble. 



72 NUTRITION AND SPECIFIC THERAPY 

Tea 

Green Black 

Per cent. Per cent. 

Water 5.96 8.2 

Caffeine 2.33 3.2 



Albumin 16.83 17.2 

Alcoholic Extract 7.05 6.7 

Dextrin 5 

Pectin 3.2 2.6 

Tannic Acid 27.1 16.4 



Chlorophyll 4.2 4.6 

Cellulose 25.9 34.0 

Mineral Matter 6. 6.2 

Pectin present in tea and many vegetables, roots and 
fruits is a kind of carbohydrate, a substance which has 
not yet been prepared in a pure state. It gives to fruit 
juices their property of gelatinizing. If fruits are too 
ripe, the properties of the pectin are lost, and the juices 
cannot be formed into jelly. 

Caffeine is a trimethyl purine and theobromine, the cor- 
responding substance in chocolate and cocoa, is a dimethyl 
purine. They are almost identical with uric acid which 
is formed as a waste product of the body. 

Chlorophyll is the green coloring matter of plants, par- 
ticularly associated with vitamine A. 

Coffee 

Per cent. 

Water 6 

Caffeine .8 

Saccharin Matter . . 4 

Tannic Acid 4.7 

Alcoholic Extract 14.1 

Fat and Oil 13.5 

Legumin 11.2 

Dextrin 1.2 

Cellulose 48.6 

Mineral Matter 4.5 



REFORMING THE INTESTINAL FLORA 73 

The caffeine and tannic acid in coffee are present in a 
much smaller amount than that found in tea, but the 
amount of each in an infusion of tea and coffee is approxi- 
mately the same because a much stronger infusion of coffee 
is generally demanded. A cup of coffee or tea contains 
about four grains of caffeine and five grains of tannic 
acid. About 35-40 per cent of the coffee used in making 
the infusion goes into solution. 

Cocoa Bean 
Per cent. 

Water 5.2 

Fat 50.4 

Carbohydrate 4.2 

Albumin 6.3 f ot i a ia a! 

Tannic Acid 5.7 (4.7 in coffee) ;**£„ c 

Gum ~2l L mtGa 3 

S Uu J 0Se . 6 *t , # ,12.3 and 3.21 

Ineobromme 8 (same as coffee) < • + > 

Cocoa Red ~~^2 ( m tea 3 

Mineral Matter 2.7 

Cocoa preparations from the bean have much less fat, 
about 26 per cent and consequently more carbohydrate, 
about 25 per cent, and more protein, about 20 per cent. 
Sweet chocolate contains about 50 per cent fat and 40 per 
cent cane sugar. Many people cannot digest chocolate 
because of its high fat content. 

Honey 

Per cent. 

Water 20. 

Dextrose 35. 

Levulose 40. 

Gums, Wax, Essential Oils, Coloring Matter, 
Mineral Matter 5. 

Rhubarb and Spinach. — This is perhaps a fruit and a 
vegetable that should be generally forbidden. Their prin- 



74 NUTRITION AND SPECIFIC THERAPY 

cipal acid is entirely different from the other vegetable 
and fruit acids such as citric, malic and tartaric. These 
acids are oxidized in the body and form carbonates. But 
the high per cent of oxalic acid in rhubarb and spinach 
is a poison, 4 and cannot be oxidized, and is excreted in the 
urine for the most part as calcium oxalate. Only a mere 
trace of this acid is found in the majority of fruits and 
vegetables, but there is a considerable amount in tea, cof- 
fee, cocoa, sorrel and pepper. McCollum 5 says there may 
be an injurious effect brought about by prolonged admin- 
istration of oxalic acid. (See Cane Sugar, Chapter VI.) 

The body produces and eliminates daily, from protein, 
fat and carbohydrate, and also from fermentation in the 
intestines, about .02 gram. 4 In eating one-fourth pound 
of rhubarb or spinach, one would ingest about four grains 
of oxalic acid or about thirteen times the amount which 
the body normally eliminates daily. (If drained, iron as 
well as oxalic acid is removed from spinach.) 

An occasional meal of spinach or rhubarb has no ill 
effects, but spinach is habitually recommended by physi- 
cians for anemic patients and infants and children as a 
daily necessity. What is the reason for this with the 
above facts in mind, and why are not quantities of lettuce 
and many other foods, — cabbage, apples, strawberries, oat- 
meal, lentils, etc., with their extremely high iron content 
recommended with the same enthusiasm as spinach. 
Spinach may have a slightly higher percentage of iron, but 
patients quickly tire of spinach and will relish larger 
amounts of these other foods for a longer period of time. 
It is the author's opinion that lettuce and cabbage (green 
is the best, — see Chapter IX) should be greatly favored 
in place of spinach. They can be cooked, but are best 
served in salads. They should be advised twice a day 

4 "A Text-book of Physiological Chemistry," Hammarsten and 
Hedin. 

6 "The Newer Knowledge of Nutrition." 



REFORMING THE INTESTINAL FLORA 75 

for anemic patients, serving them once in a vegetable 
salad and then again in a fruit salad. 

Loeper 6 has published numerous articles on the subject 
of oxalic acid in gout in the last ten years, and his experi- 
ence has demonstrated more and more the pathogenic 
action of retention of oxalic acid. It affects the liver, 
muscles, and nervous system, but the joints suffer first. 
It involves mainly the small joints of the hands and fingers, 
settling in connective tissue and bone rather than the 
cartilage and periarticular tissue for which uric acid dis- 
plays a predilection. Uric acid gout is accompanied by 
vasomotor congestion and high blood pressure, — oxalic 
acid gout by low blood pressure and anemia. 

Other symptoms of oxaluria are neuralgia, eczema, dys- 
pepsia, nervous exhaustion and mental distress. 
V. A. M.A., Sept., 1921. 



CHAPTER VII 

DIET IN THE COMMON DISEASES 

In the previous chapter the sixteen rules were outlined 
which may prevent the majority of the acute and chronic 
organic diseases and possibly some of the infectious and 
deficiency diseases. When once these have gained a foot- 
hold, the question of diet must always be of the utmost 
importance, based upon the etiology of the particular dis- 
ease; sometimes the same disease is produced by entirely 
different causes, and the diet in these cases would natu- 
rally be somewhat different. (Certain type of diabetes 
and anemia for example.) 

Hyperchlorhydria. — Chronic cases of hyperacidity are 
extremely common and the question of the diet has pro- 
voked much controversy. Some authorities advocate a 
high protein diet because the protein combines with the 
free hydrochloric acid and therefore diminishes the gastric 
acidity. Others advocate a laeto-vegetarian diet, and still 
others a carbohydrate diet based upon the experiments of 
Pawlow, which show that the gastric secretion is less 
stimulated by these substances than by protein. Von 
Noorden and Zweig are in favor of a mixed diet as they 
claim that neither protein nor carbohydrates have any 
appreciable effect upon the gastric acidity. 

The following diet has been carried out with success 
in the author's experience : — 

1. Avoid drinking with meals as water stimulates the 
flow of gastric juice. 

2. Avoid all flesh because it demands much hydro- 
chloric acid to reduce it to peptones. 

76 



DIET IN THE COMMON DISEASES 77 

3. Avoid condiments, tea, coffee and large amounts of 
cane sugar for reasons previously given. 

4. Eat little salt as this stimulates secretions. 

5. Avoid acid fruits. Eat ripe bananas, prunes, figs, 
dates, raisins, plums, pears, watermelon, grapes and baked 
apples. 

6. Eat easily digested fats, such as olive oil, butter, nut 
butters, ripe olives, — perhaps Yogurt buttermilk and 
eggnog. 

(Fats inhibit the flow of hydrochloric acid.) 

7. Foods should be taken in the form of a puree 
(vegetables, cereals and legumes) as chewing stimulates 
the flow of gastric juice. 

8. All cereals and legumes should be allowed as they 
are an important protein food and also contain much 
required carbohydrate. 

9. All roots, tubers and vegetables should be advised 
because of their high mineral and vitamine content. 

10. Eating little at one time should be urged in order 
that the food may pass out of the stomach as quickly as 
possible. Four meals a day may be given if necessary 
when the meals are small. 

Hypochlorhydria. — The majority of the rules are oppo- 
site those for hyperacidity. 

1. Highly peptogenic foods should be eaten as they 
demand much hydrochloric acid. These include cereals, 
legumes, nuts and eggs. The cereals and legumes should 
be served whole and cooked only a short time, and they 
should be thoroughly masticated. 

2. Roots and tubers should be eaten with the skins, 
especially baked potato. There should be a liberal supply of 
fruits and vegetables, eaten in the raw state as far as pos- 
sible, which requires more thorough mastication than when 
these foods are cooked, thereby stimulating secretions. 

3. Avoid quantities of fats which inhibit hydrochloric 
acid. 



78 NUTRITION AND SPECIFIC THERAPY 

4. Avoid tea, coffee, condiments, meats, cheese and 
cane sugar for reasons previously given. 

5. In some cases pure culture buttermilk may be 
advised. 

Anachlorhydria. — Foods should naturally be advised 
which make little demand upon the stomach. Small 
meals and probably four a day will prove most beneficial. 

The following foods have given good results : — 

Buttermilk (pure culture). 

Rice in all forms. 

Tapioca. 

Wheat flakes (with sterilized milk or cream if desired). 

Corn flakes. (Ripe fruits are excellent in place of 
cream.) 

Raw eggs (may be beaten and added to fruit juices). 

Pulp of potato. 

Purees of peas, beans and lentils. 

Vegetable broths. 

Vegetable purees. 

Ripe fruits (according to the patient). 

Colitis — Gastritis — Gastric Ulcer — Appendicitis — En- 
teritis. — All require practically the same diet except gas- 
tric ulcer and acute appendicitis, when generally the 
initial nourishment should be given per rectum. Rectal 
injections of glucose every other day may be given and 
sterilized milk and raw egg can be given every day. 

At first give only water and vegetable purees orally. 
Gradually other foods are added. Olive oil can be given 
to the amount of 150 c.c. a day. Two to three eggs a day 
may prove of benefit in the later stages. Strained cereal 
gruels, potato and rice purees, cauliflower and lettuce 
purees and ripe fruit juices have given good results. 

Migraine. — This may be the result of a high protein 
diet, arteriosclerosis, great muscular or brain fatigue and 
other causes. 

Follow the diet rules according to the etiology. 



DIET IN THE COMMON DISEASES 79 

Dilatation — Flatulency — Heart Diseases. — Disinfect 
the stomach and intestines by giving a diet of fruit juices 
and water for two days. (This may be omitted in heart 
diseases.) A dry dietary is advised because it promotes 
mastication, and therefore prevents overloading the 
stomach. Small quantities of food should be given four 
times a day, and no water allowed with the meals. 

The following foods are especially advised : — 

Prepared dry cereals Nuts 

Toast Raw fruits 

Corn bread Whole-grain wheat 

Baked potato with skin Raw vegetable salads 

Figs — Dates — Raisins — Popped corn 

Prunes (washed and uncooked) 

Gall-stones — Jaundice. — The following diet may some- 
times obviate an operation. The great aim is to stimulate 
all secretions through reflex action. 

Four hundred grains of cellulose (or approximately one 
ounce) a day may be advised. 

A generous amount of water probably will prove bene- 
ficial. 

A laxative diet gives good results, consisting of fresh 
vegetables, and fresh fruits eaten without paring, olive oil, 
unrefined cereals cooked a very short time, legumes, roots 
and tubers with the skins, and nuts. 

The following table will give the approximate number 
of ounces of foods necessary to furnish 400 grains of 
cellulose. These figures can be compared with those rec- 
ommended in Europe in what is called the grape cure for 
auto-intoxication, acne and allied diseases. In this cure 
about 6 pounds of grapes a day are given, approximately 
96 ounces. Naturally many of these figures are high 
because of the high per cent of water in fruits and 
vegetables. 



80 NUTRITION AND SPECIFIC THERAPY 



A variety of the following foods each day should make 
up the sum total : — 



Ounces 

Give 400 
Grains 
Raw Cellulose 

Asparagus 76 

Beans 100 

Beets 76 

Brussels Sprouts 54 

Cabbage 44 

Carrots SO 

Cauliflower S2 

Celery 57 

Green Peas 43 

Lettuce 114 

Onions 115 

Parsnips 45 

Dried Peas 14 

Baked Potato 73 

Tomatoes 99 

Turnip 61 

Prunes 40 

Apples SO 

Pears 27 

Peaches SO 



Ounces 
Give 400 

Grains 
Raw Cellulose 

Plums 53 

Cherries 40 

Red Raspberries 10S 

Huckleberries 6.5 

Blackberries 16 

Strawberries 40 

Currants 23 

Bananas 226 

Figs IS 

Apricots 32 

Cranberries 16 

Polished Rice 200 

Unpolished Rice 109 

Corn Meal 40 

Corn Flakes 40 

Dried Beans 100 

Dried Peas 13 

Lentils 20 

Graham Bread 67 

Sterilized Bran 2 



Diarrhea (Adults') 
Only water for 24 hours in severe cases. 



Rice 

Rice Flakes 
Rice Pudding 
Cornstarch Pudding 
Tapioca Pudding 
Puree of Lettuce or Cauli- 
flower 



Cereal Gruels 
White Bread Toast 
Albumin Water 
Cocoa 
Xo Sugar 



Colon irrigation and Pluto water may prove advisable 
at the onset. 



DIET IN THE COMMON DISEASES 81 

Diarrhea (Infants'). — There are several varieties of 
acute infants' diarrhea. One is caused by the dysentery 
bacillus, — B. dysenteric (Flexner), B. dysenteric 
(Shiga), B. dysenteric (Kruse), — another by a gas- 
forming bacillus, the B, aerogenes capsulatus, and very 
recently x another type has been described by K. Mita of 
Fukuoka, Japan, — that produced by the paratyphoid 
bacillus and the paradysentery bacillus. In the B. dysen- 
teric types, albumin water may prove beneficial (white of 
one egg to one cup of water 3-4 times a day) ; give plain 
cool water also. In the B. aerogenes capsulatus variety, 
cereal waters and fruit juices may prove beneficial. 

Diarrhea in infants may also be due to over- or under- 
feeding, to a mechanical obstruction, to some particular 
infection or to fat intolerance. If fermentation is the 
cause (albumin water is recommended), it is confirmed 
by the frequent, green, watery stools. 

If diarrhea is due to overfeeding or to some particular 
infection, give only water for twelve hours, and a table- 
spoon of mineral oil, "Milk of Magnesia," or Pluto water, 
or sufficient to cause a complete evacuation of the colon. 

If fat intolerance is the cause, give fat-free milk, per- 
haps modified with oatmeal water (oats contain an easily 
digested fat) and olive oil, which gives excellent results in 
many cases. (See Modification and Schedule, Chapter 
VIII.) 

Calcium caseinate milk has been employed in cases of 
fermentation. This is low in carbohydrate and fat. A. 
G. DeSanctus and L. V. Paider of New York give the 
following formula 2 : — Two-thirds ounce calcium casein is 
used to 16 ounces of whole milk and 16 ounces of boiled 
water. It is well to use % milk and % water for infants 
under four months (10 ounces milk to 20 ounces water). 
Mix the calcium casein with 4 ounces of cold water. Bring 

1 J. Infect. Dis., Dec, 1921. 
*Arch. Pediat., April, 1921. 



82 NUTRITION AND SPECIFIC THERAPY 

the milk to a boil and add the calcium casein and boil 
5 minutes. Strain, and add 16 ounces of boiled water. 

Other authorities have found pure culture lactic acid 
milk beneficial in underfed infants. 

Kidney Diseases. — The great aim is not so much to 
spare the kidney cells as to correct the cause of the dis- 
ease. Wordley has demonstrated that variations in the 
amount of protein in the diet have no effect on the amount 
of albuminous matter excreted in the urine. Bacteria and 
toxins are the chief causes. Von Noorden has concluded 
that an exclusive milk diet advocated by many physicians 
in cases of albuminuria produces very harmful results 
such as stenocardia attacks, ocular disturbances, etc. He 
recommends an average amount of water, which is con- 
trary to many authorities. 

Rice has also been greatly recommended because it is 
so easily digested and leaves no residue. The author's 
conclusion has been that quantities of polished rice and 
an exclusive milk diet would tend to promote albuminuria 
because of the high protein content in the milk and the 
low mineral, vitamine and protein content of polished rice. 
A high protein diet with lack of mineral matter, vitamines 
and cellulose probably is the cause of the majority of 
kidney diseases. The explanation is found in the chapter 
on Auto-intoxication. 

The following rules have produced excellent results : — 

1. Average amount of water between meals or a very 
little with meals. 

2. No meat, fish, fowl or game. 

3. A moderate amount of eggs (one a day if desired), 
but they are not necessary. 

4. Peas, beans and lentils as desired. 

5. All cereals are allowed. 

6. Roots and tubers are allowed. 

7. All fresh vegetables are excellent, spinach excepted. 

8. All fresh fruits are excellent, rhubarb excepted. 



DIET IN THE COMMON DISEASES 83 

9. Prunes, figs, dates and raisins as desired. 

10. All kinds of nuts as desired. ' 

11. Very little cane sugar. 

12. Little or no tea, coffee, milk or condiments. 

Gout. — The diet is practically the same as that recom- 
mended for kidney diseases. In this disease uric acid or 
oxalic acid is deposited in the joints in the form of urates 
or oxalates and for this reason, foods that produce purines 
and calcium oxalate should be more restricted. It is be- 
cause of this fact that legumes are often forbidden. Gout 
is accompanied by flatulency, high blood pressure, neural- 
gia and constipation, and sometimes by low blood pressure 
and anemia; all these complications will be benefited by 
the diet recommended for kidney diseases. (See Rule 11 ; 
Spinach and Rhubarb, Chapter VI.) 

The following foods are very rich in purines : — Sweet- 
breads, liver, kidney, sardines, yeast. 

Foods containing purines in moderate quantities are : — 
Beef, veal, mutton, pork, tongue, chicken, goose, fish, 
caviar, oysters, crab, lobster, spinach, peas, beans and 
lentils, tea, coffee and cocoa. 

There is a small proportion of purines in lettuce, rad- 
ishes, cauliflower, celery, asparagus, potatoes, carrots and 
string beans, but not sufficient to eliminate them from the 
diet for gout. Cereals, nuts, eggs and fruits are prac- 
tically free from purines. 

Pernicious Anemia. — There have been many theories 
regarding the etiology of this disease. Whatever the 
cause, diet is of primary importance, and should the dis- 
ease be produced by the B. aerogenes capsulatus, Balan- 
tidium coli (A. H. Logan), 3 or other parasite in the intes- 
tines, which some authorities claim manufactures a hemo- 
lytic toxin, then the diet becomes a still greater factor in 
the questionable cure of this disease. In this case, raw 
foods should be chosen as far as possible, and no sweet 

3 Am. J. M. 8c 9 Nov., 1921. 



84 NUTRITION AND SPECIFIC THERAPY 

milk, eggs or meats should be allowed. In certain cases 
of pernicious anemia, some eggs and pure culture butter- 
milk may be given. Inorganic iron may be recommended, 
although it has been a much disputed question whether 
inorganic iron is assimilated. Some authorities claim it 
is undoubtedly absorbed to a certain extent, and if so, 
probably produces the best results in anemias other than 
pernicious anemia. The interpretation of this fact is that 
the cause, and not the result of pernicious anemia should 
be the all-absorbing problem. If, however, certain organ- 
isms in the intestines should be one of the causes, then, in 
reforming the intestinal flora, inorganic iron might be a 
beneficial factor. An acid medium in the colon will 
antagonize these forms of life, and, therefore, should be 
produced through diet. 

Quantities of lettuce, cabbage, lentils and oatmeal 
should be given, and the other unrefined cereals and 
legumes at times. To these, add nuts well masticated, and 
a very generous quantity of the fruits and vegetables rich 
in iron, given in Chapter III, the latter prepared in salad 
form, including lettuce, cabbage, tomatoes, cucumbers, 
onions, celery, radishes, watercress, etc. 

A cathartic may be advisable at the beginning of the 
treatment, and only a limited quantity of fruit juices al- 
lowed for 24 hours, keeping the patient in bed. 

The Bulletins of The Johns Hopkins Hospital have 
been publishing during the last few years some interesting 
data on pernicious anemia, but the studies are not con- 
clusive. 

"In anemias 4 of various types the protective power of 
the serum is diminished, and is most marked in anemias 
which are hemolytic in character, and in conditions in 
which the spleen is involved." 

This statement appeals to the author as a further proof 
that the disease is caused by a bacterial toxin, since in 

4 Bull. Johns Hopkins Hosp., Oct., 1921. 



DIET IN THE COMMON DISEASES 85 

mammals a great number of the specific antibodies are 
made in the spleen. Professor Preston Kyes 5 has been 
conducting this extremely interesting research. Professor 
Kyes found that in immunized rabbits to certain antigens 
(infectious organisms and other foreign protein bodies), 
the antibody content of the spleen was one hundredfold 
the antibody content of the serum. 

D. H. Morris and F. D. Bullock 6 say the work done 
regarding the relation of the spleen to infectious diseases 
is fragmentary, unconvincing and conflicting. Concern- 
ing work hitherto done, the most convincing is that of 
Pfeiffer and Marx. They claim that while removal of 
the spleen prior to the immunizing process did not prevent 
the formation of immunity, it was found that if the im- 
munization was attempted before splenectomy, immunity 
failed subsequently to develop. These results of Pfeiffer 
and Marx for cholera have been confirmed by numerous 
other observers. 

Splenectomized animals can weather a critical disease, but 
in this case the bone marrow or the lymphatic system prob- 
ably compensate for the loss of the spleen. 

The blood changes can be said to furnish positive evidence 
of an impaired ability on the part of the body to resist infec- 
tion, and it seems possible that the anemia and leucocytosis 
which are temporarily observed are an indication of increased 
susceptibility to infection. 

The work of Hektoen points strongly to the spleen and 
other lymphatic tissues as being concerned in the production 
of lysins, agglutenins, opsonins and precipitins. 

One type of the B. influenzae produces a hemolytic toxin, 
and streptococci 7 from the throats of scarlet fever patients 
produce such a toxin. If these two types of bacteria, as 

6 J. Immunology, Feb., 1916; J. Infect. Dis., Sept., 1915, and 
March, 1916. 

6 Annals of Surgery, Nov., 1919. 

7 Bull. Johns Hopkins Hosp., Oct., 1921. 



86 NUTRITION AND SPECIFIC THERAPY 

examples, produce a hemolytic toxin, is it not reasonable 
to assume that another variety of bacteria produces perni- 
cious anemia, especially since this disease is most grave in 
cases where the spleen is affected which produces probably 
the majority of antibodies in mammals ? For this reason it 
seems advisable to try to eliminate the questionable organ- 
isms from the intestines as far as possible, going on the 
supposition that they can produce a hemolytic toxin which 
is absorbed into the blood, which may produce this type 
of anemia. The diet recommended will prove of benefit 
in either case, and may aid the spleen in its production of 
antibodies for another variety of bacteria producing a 
hemolytic toxin elsewhere, causing this disease. In other 
words, choose a diet which will give the spleen every pos- 
sible opportunity to manufacture the specific antibodies 
within its power for this disease, and broadly speaking, 
for every infection. 

The persistent absence of hydrochloric acid is practically 
a constant finding in cases of pernicious anemia. It is 
often present years before the blood shows any of the 
typical changes. For this reason the disease should be 
suspected in its infancy and preventive measures under- 
taken. (See S. S. Zilva, Chapter IV.) 

Fevers. — Tuberculosis, — Typhoid Fever, — Diphtheria, 
— Scarlet Fever, — Pneumonia, — Influenza, — Measles, — 
Whooping-Cough, — Bronchitis. 

The terrible wasting, caused by toxins acting upon the 
cells, which results from fevers, may be prevented by a 
free use of carbohydrate, for it spares body protein and 
fat. It also has the advantage of not producing putrefac- 
tion in the colon. 

Every fever patient should have 8-12 pints of liquid 
daily — some may be given per rectum. 

A diet of fruit juices is excellent, 6-8 pints daily when 
this is the principal food. This can be given every hour 



DIET IN THE COMMON DISEASES 87 

or five or six times during the day. Malt sugar, 4—6 oz. 
a day may prove beneficial in severe cases. 

As the patient improves, semi-solid foods should be 
added, such as vegetable purees, potato soup, soft eggs, 
legume purees, cereal purees and gruels. Gradually add 
the more solid foods given under the 16 antitoxic rules. 

Torry 8 has demonstrated the striking effect of various 
high-Calorie diets on the fecal flora of typhoid patients. In 
some cases the addition of 250-300 gms. of lactose a day 
to the other ingredients of the ration brought about a trans- 
formation of the fecal flora from the ordinary type to one 
strongly dominated by B. acidophilus. 

In more recent investigations on dogs he has further 
established the promptness and uniformity with which they 
respond to diet changes in their predominant alimentary 
bacteria. 

Contrary to most authorities, it is the author's opinion 
that milk should not be given in typhoid fever, because it 
is an excellent culture medium for the typhoid bacillus. 

The amount of food and the number of meals a day 
will depend upon the patient. 

In tuberculosis some authorities have advised an ultra 
liberal intake of food regardless of the digestive disturb- 
ances which might result. Forced feedings and a high 
protein diet so commonly given are decidedly harmful. 
Not over 60 grams of protein a day should be allowed for a 
man of average weight. 

All the foods included under the 16 antitoxic rules 
should be given. 

Eczema — Asthma — Urticaria. — These afflictions may be 
the result of anaphylaxis brought about by some special 
protein in the food. They may be the result of auto-in- 
toxication. Follow the 16 antitoxic rules, — and if neces- 
sary eliminate different protein foods with intervals of 

*J. M. Research, Jan., 1919. 



88 NUTRITION AND SPECIFIC THERAPY 

time sufficient to prove that the particular food eliminated 
is or is not the cause. 

Diabetes. — Diabetes mellitus has probably always been 
associated with some form of constipation which existed 
before the sugar appeared in the urine. This suggests 
that auto-intoxication may be the probable cause of this 
particular form of the disease. 

Elliott P. Joslin 9 has recently published considerable 
literature on the association of diabetes with obesity, which 
again suggests a toxic condition from overfeeding. 

It has been claimed by many that too high a carbohy- 
drate diet is the cause of diabetes ; others- have claimed 
that too high a protein diet is the probable cause which 
has overtaxed all the organs and tissues of the body with 
the result that the liver is no longer able to store glycogen, 
and the pancreas cannot secrete its internal secretion neces- 
sary for the oxidation of the sugar in the blood. 

The author's own conclusion is that neither a high car- 
bohydrate nor a high protein diet is the cause, but that 
the real cause is a combination of a generous meat diet 
(producing an excess of toxins) with a refined carbohy- 
drate diet, both lacking in mineral matter and in peristal- 
tic stimulation. Lack of vitamines also may play a certain 
role in its causation, as they appear to bear a certain rela- 
tion to the proportion of the other food principles ingested. 

Until recently the diet has been carbohydrate free as 
far as possible, — and even in the latest literature it has 
been pointed out by a number of writers that the exclusion 
of fruits and many vegetables is necessary because of their 
content of carbohydrate. It is for this reason that some 
physicians to-day employ the so-called "thrice-cooked 
vegetables," which are prepared by boiling and draining 
three times in order to eliminate as much soluble carbo- 
hydrate as possible. 

The most generally discussed cure is some modified form 

•J. A. M. A., Jan., 1921. 



DIET IN THE COMMON DISEASES 89 

of the Allen Cure, which is used in hospitals, but which 
can also be carried out at home. 

The main points in connection with this diet are the 
following: — The patient is put to bed and "starved" for 
1-3 days or until sugar free. As soon as the sugar has 
disappeared in the urine, he is placed upon a 5 per cent 
carbohydrate vegetable diet, and the diet is gradually 
increased, perhaps up to the 20 per cent carbohydrate 
foods. At the* same time eggs, meat, cereals, legumes and 
nuts are given to test the patient's protein tolerance and 
fats are given to* test the fat tolerance. This diet is in no 
way monotonous, — the principal factor emphasized being 
to reduce the amount of all foods, and keep the reduction 
as low as possible, according to the patient's tolerance of 
protein, fat and carbohydrate. 

According to Allen, life, strength and assimilation can 
be preserved for a much longer time by a degree of under- 
nutrition suited to the severity of the case, and in this 
connection he emphasizes a limitation of fat in the diet. 

The author's conclusion in regard to this diet must be 
obvious. All meats for diabetics are harmful, and thrice- 
cooked vegetables are practically worthless with their great 
mineral, vitamine and carbohydrate loss, and the cellulose 
robbed of its great value. A certain amount of carbohy- 
drate is absolutely necessary, a certain amount of protein 
is absolutely necessary, and to a smaller degree a certain 
amount of fat is necessary, while the vital importance of 
the mineral raatter and vitamines need not be repeated: 
Raw fruits and vegetables (some may be cooked) are 
excellent in diabetes for- their carbohydrate and mineral 
salts, the very sweet fruits, especially plums and bananas 
being excepted. The carbohydrate of potato, oats and the 
soy bean seems to be particularly well borne in this dis- 
ease, according to some authorities. 

Von Noorden was the first to point out that diabetics 
were greatly benefited by a diet principally of oatmeal, 



90 NUTRITION AND SPECIFIC THERAPY 

perhaps for a week or two. Since his announcement the 
giving of oatmeal in cases of diabetes has been extensively 
employed. Large quantities of oatmeal in the diet seem 
to have the best results in the most severe cases, while in 
the very mild cases it is not well borne. The soy bean 
seems to have the same beneficial effects as oatmeal in 
some cases. 

Von Noorden, following the advice of Mosse, has also 
recommended the potato as an excellent food in diabetes. 

The author regards the value of oatmeal in the diet for 
diabetes as being attributed to the excellent supply of 
mineral matter, the particular kind of protein, the higher 
percentage of fat and cellulose, and the somewhat lower 
proportion of starch, as compared with the other cereals. 
The following table gives the chemical composition of 
wheat and oats which will serve to demonstrate the state- 
ment just made: — 

Oats Wheat 

Protein 11.8 per cent. 11.8 

Fat 5.0 " " 2.0 

Carbohydrate 59.7 " " 72.0 

Mineral Matter 3.0 " " 1.9 

Cellulose 4.5 " " 1.8 

The potato may possess a "complete protein" (see 
Chapter I), although the proportion is very low. Its 
mineral content is excellent and high. 

Soy beans also have a high per cent of a "complete pro- 
tein." They are also high in fat and mineral matter, 
having a larger amount than oats. The carbohydrate is 
about half that found in oats. (See Chemical Composi- 
tion, Chapter X.) 

It would seem that oats and soy beans are much better 
balanced foods than wheat. This fact may solve the rea- 
son in some cases for the excellent results obtained through 
their use in diabetes. It hardly seems plausible that there 
can be any special inherent quality in the particular kind 



DIET IN THE COMMON DISEASES 91 

of carbohydrate in these foods. Different starches have 
different gelatinization points, and some are digested more 
promptly than others, but they all are reduced to the same 
simple products in digestion. For this reason it is diffi- 
cult to reason that one variety of starch can claim priority 
over that of another in diabetes. There seems to be only 
one factor that might cause one variety of starch to be 
superior to another, — that is that lactic acid might be 
produced in greater amounts from some than from others 
which would prevent bacterial putrefaction in the intes- 
tines, and decrease the amount of toxins that enter the 
circulation. 

Legumes can be given for their protein. A few eggs 
may be allowed also for their protein. Any of the nuts 
may be included in the diet for their protein (fat and 
mineral content), except in the severe cases, when fats 
must be greatly restricted. 

Sajous, 10 the eminent authority on internal secretions, 
says that diabetes mellitus is characterized by an excessive 
excretion of sugar which is due to the hypersensitiveness 
of the test-organ, and to the presence in the blood of waste 
products or other irritating substances which keep this 
organ, and through it the adrenals, overactive. An excess 
of adrenoxidase is thus produced and the intrinsic metab- 
olism of all tissues is correspondingly activated. The pan- 
creas is thus caused to secrete, besides its other ferments, 
an excess of amylopsin, and consequently the hepatic and 
muscular glycogens are converted into sugar with unusual 
rapidity, and the surplus of sugar formed is eliminated 
by the kidneys. The pancreas is finally destroyed organ- 
ically through excessive stimulation to the point where its 
function is inhibited with cessation of the production of 
the internal secretion from the Islands of Langerhans 
necessary for oxidization of sugar in the blood. Sajous' 
conclusion is that disease of the pancreas is not the pri- 

10 "The Internal Secretions and the Principles of Medicine." 



92 NUTRITION AND SPECIFIC THERAPY 

mary cause of diabetes, but that the pancreatic lesions are 
due to overstimulation of this organ. 

If this is true, combined with the fact that a surplus of 
sugar is formed by the body cells, "the prevailing method 
of depriving the patient of starches and sugars is unscien- 
tific. The morbid process being an excessive consumption 
of these substances in the body at large, including the 
hepatic glycogen, their withdrawal from the blood can 
have but -one effect, namely, to place at the mercy of the 
amylolytic triad of the blood what carbohydrate remains 
in the tissues. The body is thus depleted of physiological 
components of the highest importance to its welfare. The 
sugar in the urine naturally diminishes, but this does not 
prove in the least that the disease is counteracted ; it only 
shows that the patient has been drained effectively of his 
main sources of muscular heat and energy. Nor does the 
meat diet to which the patient is relegated protect him 
against the renal complications feared, since glycosuria is 
known frequently to persist under such a diet, and to pro- 
mote the appearance of acetonuria and acidosis. That 
abstention from starches and sugar is harmful under such 
conditions is shown by the fact that the restoration of car- 
bohydrates often causes both acetonuria and acidosis to 
disappear." 

To the above objections it may be added that if carbo- 
hydrates are withdrawn, the protein of the food is required 
to produce heat and energy instead of being used for main- 
taining nitrogen equilibrium. As long as enough sugar 
is oxidized, there is no harm in a small proportion, or even 
a considerable amount, passing through the kidneys. The 
presence of the sugar itself does no harm, but the cause 
of the sugar does do harm. 

Croftan states that in many cases it is well known that 
the sugar excretion only stops when the amount of meat is 
considerably reduced. This seems to be in line with 
Sajous' statement that the formation of wastes or irritat- 



DIET IN THE COMMON DISEASES 93 

ing substances finally destroys the normal functioning of 
the organs of the body. 

It is also known that 58 per cent n of protein is avail- 
able as dextrose in metabolism (casein and a few others 
excepted), which fact would further account for the ap- 
pearance of sugar in the urine on a protein diet. There 
is no necessity for a carbohydrate radical in casein since 
milk contains a large percentage of sugar. 

Croftan further states that withdrawal or reduction of 
meat appreciably increases the tolerance of carbohydrate. 
He urges, moreover, "that the chief danger incident to 
complete withdrawal of carbohydrates is . . . acidosis and 
coma," and also "that it is surprising how often the admin- 
istration of a little carbohydrate in cases that are on a 
rigid diet, or of added carbohydrate in cases that are receiv- 
ing only small quantities of carbohydrate will cause all 
these dangerous phenomena to disappear." 

Sajous relates that "a lugubrious commentary upon the 
true meaning of all these facts is suggested by the case of 
a man in the last stages of .the disease observed by Lepine 
to whom sugar was granted owing to his hopeless condition, 
and who began to improve. This suggested honey as an 
appropriate food." 

Many authorities advise alkaline mineral water. But 
if the patient eats fresh raw fruits and vegetables daily, 
this may not be necessary. 

Sajous also defines a second type of diabetes which he 
calls asthenic glycosuria, due to hypoactivity of the ad- 
renal system, caused by diseases such as gout, syphilis, 
influenza, by poisons that result from worry, exhaustion 
or grief and by injury. The pancreas is reduced, there- 
fore, as far as its functions are concerned, to the condition 
which prevails in the late stage of diabetes mellitus. Diet 
in this type plays no particular role as far as the diabetes 
itself is concerned. 
u Bull. Johns Hopkins Hosp., June, 1917. 



94 NUTRITION AND SPECIFIC THERAPY 

The author has quoted Sajous at considerable length as 
his lucid explanation of the causes of diabetes is of great 
significance in connection with the diet recommended for 
this disease in this book. 

The following recent conclusions of Lenne 12 bear out 
still further the points emphasized in this disease : — 

It is not the purpose of treatment to eliminate glycosuria 
under all circumstances. Often we must be content if we 
can get the diseased organism to perform its functions rea- 
sonably well so as to improve the general condition of the 
patient both subjectively and objectively, even though the 
glycosuria persists. Many patients feel better in every way 
on a more liberal diet with slight glycosuria than they do on 
a stricter diet with sugar-free urine. If we recognize the 
different effects of various proteins on glycosuria, we must 
not forget that there is also a marked difference in the way 
various carbohydrates affect different types of patients. Some 
patients assimilate one carbohydrate better, and some an- 
other. For example, it is wrong to assume that oatmeal is 
going to agree equally well with all patients, — it will be 
found good for some and bad for others. The same is true 
of potato starch and rice starch. If on substituting other 
carbohydrates, it is found that the capacity for improvement 
in assimilation has been lost, this is the time when further 
limitation of proteins and the introduction of fast days are 
indicated, after which the diseased organism takes on new 
strength, as is shown by a better assimilation of carbohy- 
drates. If such reaction is waited for in vain, in spite of all 
measures, it is a bad sign. 

Dr. W. H. Holmes 13 has published an article in which 
he simplifies the method of calculation of protein, fat and 
carbohydrate of Dr. R. T. Woodyatt by the preparation of 
tables which will prove of value to those interested in the 
subject of diet in diabetes. 

12 J. A. M. A., Oct., 1921. 
» J. A. M. A., Jan., 1922. 



DIET IN THE COMMON DISEASES 95 

He states that, according to Woodyatt, the ratio of the 
higher fatty acids to glucose in the diabetic diet should be 
as 1.5 is to 1. if acidosis is to be avoided, and that 1 gm. 
per kilogram body weight is necessary to maintain nitro- 
gen equilibrium. 

The total glucose tolerance is roughly the amount of 
glucose in the carbohydrate foods, plus 58 per cent of the 
protein and 10 per cent of the fat, minus the amount of 
glucose eliminated in the urine. 

Arteriosclerosis. — The diet should be practically the 
same as that for diabetes with emphasis laid upon reducing 
the amount of food as far as possible. 



CHAPTER VIII 

INFANTS' DIETS; CHILDREN'S DIETS 

The literature on the subject of infants' and children's 
diets is most confusing. There are very few authors who 
agree on the diet for a bottle-fed infant, whether the infant 
has a normal digestion or one that falls into the category 
of the many abnormal varieties common in infancy. 

The great desire in this chapter has been to reduce con- 
fusion to a minimum as far as possible, and to present the 
subject in a concise form, with scientific reasons for all 
conclusions, although the author is fully aware that the 
conclusions may fall short of the truth. 

The great difficulty with the question of bottle-fed in- 
fants lies in the fact that it is necessary to give a food that 
nature did not manufacture for the human infant. Some 
modification is therefore required, but the human infant's 
digestive tract is not adapted even to the most perfect 
modification. Infants possess many idiosyncrasies, and 
the natural consequence is multiple variety and formulas 
for modifications of milk, each aiming to satisfy the par- 
ticular demands of each individual infant deprived of 
mother's milk. Confusion in this subject is inevitable, 
and the author makes no attempt to outline a diet for the 
innumerable individual cases that require special formulas. 
The aim in this chapter is to give modifications and diets 
that suit the normal infant deprived of mother's milk, 
with a few suggestions for some difficult cases. There are 
many normal cases which have been diagnosed as difficult, 
simply because the right modification was not used in the 
beginning. 

96 



INFANTS' DIETS; CHILDREN'S DIETS 97 

The difficulties in connection with the diet of an infant 
should not be numerous when the infant is breast fed. If 
the mother is in good health, the child receives milk that 
has the five food principles in the right proportion, and 
milk that is bacteria free. The Bacillus bifidus is in the 
intestines to combat putrefaction. 

But when the mother's milk is lacking in amount or in 
the proper proportion of the five food principles, compli- 
cations arise. Cow's milk or milk from some other animal 
must be resorted to in part or in whole, a food for an 
entirely different kind of mammal. This means a great 
change in the intestinal flora, and putrefaction of some 
kind takes place, and the way is paved for the numerous 
ailments and diseases of infancy and childhood. Faulty 
diet on the mother's part generally is to blame for inferior 
quality or lack in quantity in her milk. 

If mother's milk is lacking only in quantity, it should 
be complemented by modified milk, — that is, the infant 
should receive breast-milk from one or both breasts, empty- 
ing them completely, and then enough bottle-milk to 
complete the feeding. Through this method, there is a 
greater production of mother s milk than if the infant is 
given a certain number of breast feedings, and then a 
certain number of bottle feedings a day. 

J. C. Drummond and K. H. Coward 1 state one prelimi- 
nary experiment shows that the winter feeding of cows 
may have the effect of lowering the food value of the milk 
unless considerable care is exercised in the selection of the 
animal's diet. The natural conclusion is, if this is true, 
human milk can be altered in the same way. 

G. A. Hartwell, 2 experimenting with rats, concludes 
excess protein in the mother's diet probably alters the 
composition of the milk, and after a time causes the milk 
supply to cease. Excess carbohydrate appears to have no 

1 Biochem. J., Nov., 1920. 
*Biochem. J,, Vol. XV, No. 1, 1921. 



98 NUTRITION AND SPECIFIC THERAPY 

effect. Excess fat in the mother's diet has a slightly de- 
pressing effect on the growth of the litter, but the absence 
of fat seems to make practically no difference. (Accord- 
ing to these experiments, excess protein in the mother's 
diet may be responsible for the large number of infants 
deprived of mother's milk.) 

A comparison of cow's milk with human milk will em- 
phasize the inevitable results following the use of cow's 
milk. 

Cow's Milk Human Milk 

Water 87. -88. per cent. 87. per cent. 

Protein 3. - 3.5 " " 1.6 " " 

Fat 3.5- 4.5 " " 3.1 " " 

Carbohydrate... 4.-5. " " 6.2 " " 

Mineral Matter. .7 " " .27 " " 

Reaction Amphoteric Reaction Slightly Alkaline 

It will be noticed that human milk is lower in all the 
food principles but one. This is the sugar. The ques- 
tion of primary importance is, — how similar to human 
milk can cow's milk be made ? An attempt will be made 
to answer this question in detail. 

The superiority of cow's milk in these food principles 
is due to the more rapid growth of the calf. The calf 
doubles its weight in seven weeks; the human infant re- 
quires six months to double its weight. 

This pertinent comparison can be carried to the milk 
of other animals. Rabbit's milk contains three times as 
much protein as cow's milk and five times as much calcium 
and phosphorus, and the rabbit doubles its weight in six 
days. 

In this connection it is highly interesting to note the 
composition of the milk of other animals given by Konig 
(Hammarsten and Hedin). (See p. 99.) 

Under the fat is included also the lecithin, and the pro- 
portion of lecithin is greater in woman's milk than in cow's 
milk. The reason for this is that the infant requires this 



INFANTS' DIETS; CHILDREN'S DIETS 99 



Dog ... 
Cat 

Goat . . . 
Sheep . . 
Cow . . . 
Horse . . 

Ass 

Pig .... 
Elephant 
Dolphin 
Whale . 



Water 


Protein 


Fat 


Sugar 


754.4 


99.1 


95.7 


31.9 


816.3 


90.8 


33.3 


49.1 


869.1 


36.9 


40.9 


44.5 


835.0 


57.4 


61.4 


39.6 


871.7 


35.5 


36.9 


48.8 


900.6 


18.9 


10.9 


66.5 


900:0 


21.0 


13!0 


63.0 


823.7 


60 % .9 


64.4 


40.4 


678.5 


30.9 


195.7 


88.5 


486.7 




437.6 




698.0 


94.3 


194.0 





Salts 

7.3 

5.8 
8.6 
6.6 
7.1 
3.1 
3.0 
10.6 
6.5 
4.6 
9.9 



substance for muscles, blood corpuscles, blood plasma, 
lymph, bile, bone marrow, spinal marrow, and for the 
development of the nerves and brain, especially the myelin 
sheath of the motor nerves, which 3 may serve to prevent 
the spreading of impulses from one fiber to another and 
as a medium of nutriment for the axis cylinder. A calf, 
however, is born with its nervous system practically de- 
veloped. Its movements are coordinated, and it can go 
after its food and kick with a purpose in mind. 

According to Burow, there are 3.05 parts of lecithin 
to every 100 parts of protein in human milk, and only 
1.40 parts to every 100 parts of protein in cow's milk. 

Levene and Rolf 4 of the Rockefeller Institute for Medi- 
cal Research have published some interesting results con- 
cerning lecithin in the brain. It has the same composition 
as that of egg yolk. Lecithins differ in the character of 
their fatty acids. 

The question of the lesser amount of lecithin h woman's 
milk is a serious problem as this deficiency has not yet 
been made up in the modification of cow's milk. 

The author had considered the addition of a small 

8 Albert P. Mathews, "Physiological Chemistry." 
V. Biol Chem., May, 1921. 



100 NUTRITION AND SPECIFIC THERAPY 

amount of egg yolk, using in this case a little less cream in 
the modification, or legume water in place of cereal water 
to supply the desired lack of lecithin in cow's milk. But 
circumstances prevented the completion of this experi- 
ment. The egg yolk might also furnish certain amounts 
of required amino-acids, from the albumin and vitellin, 
which are low in cow's milk, and iron which is low in 
modified cow's milk. (See page 135.) 

The following table gives the amounts of lecithin in the 
cereals and legumes according to Bunge : — 

One hundred grams dried substance yields milligrams lecithin 
as follows : — 

Peas 1050 Barley 470 

Lentils 1700 Eye 570 

Beans 1000 Corn 250 

Wheat 430 Buckwheat 530 

The yolk of a hen's egg weighs about 15 grams, of 
which, according to Parke, 471.9 parts are water and 528.1 
parts are solids. Of these solids, 107.2 parts are lecithin. 

Not only does cow's milk contain a much greater pro- 
portion of protein than woman's milk, but the proteins 
differ in themselves. There are two kinds of protein in 
milk, — casein and albumin. Cow's milk contains six to 
ten parts of casein to one part of albumin, while human 
milk contains only two to five parts of casein to one of 
albumin. According to Szontagh, cow's milk casein de- 
velops paranuclein in the stomach, while human milk 
casein does not. The casein from human milk is pre- 
cipitated with greater difficulty in the stomach, and the 
clot formed from it is not tough and large as in cow's milk, 
but small and flocculent. This advantage will be dis- 
cussed in detail further in the chapter. 

The fat in the two kinds of milk also differs. The fat 
of human milk, according to Buppel and Laves, is poorer 
in volatile fatty acids, and the non-volatile fatty acids 
consist of one-half oleic acid A which is a larger proportion 



INFANTS' DIETS; CHILDREN'S DIETS 101 

than is found in cow's milk ; therefore, the fat of human 
milk has a lower melting-point and is more digestible than 
that of cow's milk. In human milk 2.5 per cent of the 
total fat consists of volatile fatty acids and in cow's milk 
27 per cent of the total fat consists of these acids. It is 
for this reason that some physicians are recently advocat- 
ing the use of olive oil in modified cow's milk. This con- 
sists almost wholly of triolein and tripalmitin and is free 
from the volatile fatty acids found in so large an amount 
in cow's milk. The proportion recommended is 1 tea- 
spoon to every 4 ounces of whole milk. (See schedule in 
this chapter for milk modification for "bottle-fed infants.) 
Should diarrhea or vomiting appear, the fat should be 
reduced. 

Many investigators 'have analyzed the mineral matter 
in cow's milk and woman's milk. Bunge's figures are 
often quoted. The mineral matter of human milk is much 
better assimilated by the nursing child. Calcium and 
phosphorus are present in much smaller amounts in human 
milk, there being six times as much calcium and three 
times as much phosphorus in cow's milk. In human milk 
the phosphorus is almost entirely in an organic form, while 
in cow's milk less than one-half is in this form. In view 
of the fact that phosphorus is extremely necessary to the 
infant, and that the organic compound is much more 
easily assimilated than the inorganic compound, it must 
be admitted- that the difference in this respect is a serious 
one for the bottle-fed infant. 

The only food principle that is the same in kind in the 
two species of milk (water not considered) is the milk 
sugar, but in quantity human milk is superior. The en- 
zymes;, internal secretions and vitamines all have their dif- 
ferences. In other words, a truly humanized cow's milk 
is an absolute impossibility. New modifications arise 
every year, but all fall short of the perfect food for the 
human infant. 



102 NUTRITION AND SPECIFIC THERAPY 

For these reasons the author concludes that a the milk 
of one species of mammals cannot be substituted for that 
of another without injury. The child that is bottle-fed 
is apt to prove a weakling, an easy prey to the diseases of 
childhood, and an heir to the many diseases of adult life." 

But if cow's milk is absolutely necessary for an infant, 
how should it be prepared and modified ? Some author- 
ities say it should be given raw, others say pasteurized, 
while still others say sterilized. In connection with these 
important questions, most of the authorities say it should 
be modified in some way. In order to understand the dif- 
ferences in these milks, the advantages and disadvantages 
of each will be considered. 

Sterilizing milk means heating it to 110° C. for about 
five minutes (milk boils at a higher temperature than 
water). 

Czerney and Keller give the following chemical changes 
produced by sterilization : — 

1. The milk sugar is caramelized under the formation 
of lactic acid. 

2. The coagulated casein and albumin are brought by 
the acid to an early precipitable condition. 

3. The rennet action on milk 'is very much impaired 
through the fact that the calcium salts are in part 
rendered insoluble. 

4. The 4 milk gases, especially carbonic, are expelled. 

5. The ferment action of the milk is destroyed. 

6. The fat in part separates from its emulsified state. 

7. The lecithin is split up and the more organic phos- 
phorus combinations of the milk are more or less 
changed into inorganic. 

8. Boiled milk undergoes putrefaction, raw milk does 
not. 

9. The taste of the milk is disagreeably changed. 



INFANTS' DIETS; CHILDREN'S DIETS 103 

10. The antiseptic and antitoxic properties of the milk 
are lost. 

11. Hydrogen sulphide is recognized if the milk is 
boiled longer than five minutes. 

To the above changes may also be added the bacterial 
changes, since cow's milk is never sterile by the time it 
reaches the consumer. 

Sterilization destroys all bacteria, including the lactic 
acid bacillus and all pathogenic bacteria with the exception 
of certain spores which require a temperature of 120° C. 
for 15 minutes to destroy them. 

In view of all these changes, what are the advantages 
to be gained in sterilized milk ? One of the great advan- 
tages lies in the fact that it kills all pathogenic bacteria. 
The second great advantage is found under the second 
change given above, for when the rennet action on the 
milk is impaired, the casein does not form in a tough mass, 
but rather in a flaky mass which resembles that of human 
milk in the stomach, and in this form it is much more 
readily digested. 

The disadvantages which result from the sterilization of 
milk are : — the lactic acid bacillus is killed which antago- 
nizes the putrefying and pathogenic bacteria, and when 
the former are destroyed, the latter can develop with much 
greater rapidity ; the emulsification of the fat is destroyed, 
the protein is coagulated, and so is harder to digest; the 
enzymes and any similar substances are for the most part 
destroyed, all of which are most necessary for normal 
health. It is claimed also that sterilized milk produces 
constipation. 

However, when the advantages and disadvantages of 
sterilization are weighed against each other, the result is 
in favor of the sterilized milk, for the worst objections 
against it can be overcome in the following ways. To 



104 NUTRITION AND SPECIFIC THERAPY 

prevent the multiplication of harmful bacteria because of 
the destruction of the lactic acid bacillus, sterilized, modi- 
fied milk should be prepared with the greatest care (see 
rules for milk modification in this chapter) and should 
never be used when over 24 hours old. The enzymes and 
vitamines are for the most part destroyed and constipation 
may also be produced, but these disadvantages are over- 
come by the feeding of certain amounts of orange juice, 
or substitute, starting when the infant is only a few days 
old, and increasing the amount as the infant grows older. 
The orange juice has an abundance of these substances 
destroyed in the milk, either through raising it to the boil- 
ing point or through the aging of the milk. 

The coagulation of the protein, the destruction of the 
emulsification of the fat, and the change, in part, of the 
organic phosphorus into an inorganic form, are objections 
that cannot be overcome, but these are small in the mind 
of the author, compared to the objections found in using 
raw or pasteurized milk. 

Pasteurized milk is milk that should not contain over 
50,000 bacteria per c.c. 

The temperatures and time vary which are used for 
the pasteurization of milk. Generally it is heated to 
60° C. or 140° F. for 20 minutes. Some authorities give 
70° C. or 158° F. 

Pasteurized milk has the following characteristics : 

1. The food principles, namely the protein, fat and 
mineral matter, are not affected. 

2. The enzymes, vitamines and internal secretions are 
partly destroyed. 

3. The clot in the stomach is not made more digestible. 

4. It does not undergo putrefaction as readily as steril- 
ized milk as the lactic acid bacillus is not destroyed. 
(This bacillus is destroyed at 93.3° C. in 30 min- 
utes.) 



INFANTS' DIETS; CHILDREN'S DIETS 105 

5. It does not kill the gas-forming bacillus (bacillus 
aerogenes capsulatus), — also certain alkali and pep- 
tonizing bacilli survive. 

6. It may or may not kill the tubercle bacillus. This 
bacillus is sometimes destroyed at 60° C. in 10 min- 
utes, while sometimes a temperature of 70° C. for 
one hour is required, according to some investigators. 

7. It does kill most pathogenic bacteria such as those of 
diphtheria, scarlet fever, dysentery, cholera, typhoid 
fever, infantile paralysis, etc. 

In view of these changes, what are the advantages to be 
gained in pasteurized milk? The principal advantage 
lies in the fact that it destroys most pathogenic bacteria 
and does not destroy the lactic acid bacillus. The second 
advantage is the fact that the protein is not coagulated, 
the fine emulsification of the fat is not destroyed and the 
organic mineral matter is not rendered inorganic. 

The disadvantages in pasteurization are the follow- 
ing: — it does not kill all pathogenic bacteria; it does kill 
some of the enzymes and similar substances; it does not 
render the casein clot in the stomach soft and flocculent. 

In the opinion of the author, in spite of the fact that 
there are a few advantages in pasteurized milk, the dis- 
advantages are such that there is no question as to the 
superiority of sterilized over pasteurized milk. 

Raw milk has some of the same objections of pasteur- 
ized milk, namely a possibility of containing many patho- 
genic bacteria and of forming a dense casein clot in the 
stomach. 

Raw milk has in its favor the fact that the food prin- 
ciples, protein, fat and mineral matter are in their natural 
form, and the enzymes and vitamines are unchanged if 
the milk is absolutely fresh. But the disadvantages of 
raw milk, even though certified, are so great in the author's 
opinion that there should be no question as to the superior- 



106 NUTRITION AND SPECIFIC THERAPY 

ity of sterilized milk, with orange juice or its substitute 
given in connection with it. (See chapter on Vitamines.) 
It is interesting at this point to quote some of Dr. 
Enunett Holt's statements concerning cow's milk. 

A calf at birth usually has eighteen teeth, indicating its 
early capacity for digesting other food than milk. . . . The 
human infant does not acquire teeth until the seventh or 
eighth month, a strong suggestion that up to this time, other 
food is unnecessary for normal growth. 

In the case of infants who are artificially fed this is a 
serious question. " Although the defects of cow's milk 
have not been wholly understood, the great advantages 
have lately been seen of the earlier use of other articles 
of diet, — fruit juices, egg, fresh vegetables, beef juice and 
broth." The author does not recommend the latter two. 

Osborne and Mendel in 1914 found that the gain in weight 
with 9 per cent of the food solids in the form of casein was 
very low unless cystine (amino-acid) was added, but if the 
casein was doubled to 18 per cent a normal gain in weight 
was seen. This important fact may shed light on some fail- 
ures and successes in infant feeding. 

Dr. Holt 5 says : 

We once thought we were supplying the infant's protein 
needs when we gave as much protein in cow's milk as the 
protein in woman's milk. Evidently we were wrong. It 
now seems clear that some of our failures were not due to the 
fact that we were giving too much fat, but that we were not 
supplying in the protein given the amino-acids required for 
normal growth. 

In other words, the infant requires more cystine for 
growth than the calf. 
6 Arch. Pediat., Jan., 1916. 



INFANTS' DIETS; CHILDREN'S DIETS 107 

In a more recent article, 6 Dr. Holt repeats his conclu- 
sions given in the previous article: — Vegetable proteins 
are low in amino-acids necessary for growth, while animal 
proteins are much richer in these acids. While vegetable 
proteins might be sufficient for maintenance, the animal 
proteins are needed for growth in children. Woman's 
milk is high in amino-acids, cow's milk is much lower. 
Therefore it is necessary to give two or three times as much 
protein as is contained in woman's milk. 

It was stated in conclusion that no experiments had 
been done, nor in fact was it possible to determine the 
exact protein requirement of growing children. 

E. V. McCollum, N. Simmonds and W. Pitz, 7 how- 
ever, are convinced they have demonstrated otherwise, 
for gelatin containing 6 per cent lysine, added to a mix- 
ture of wheat and oats, does not improve the protein which 
is lacking in lysine. But the addition of wheat gluten to 
either wheat or maize kernel proteins supplements them 
so as to improve growth. They therefore conclude the 
improvement is produced through a higher protein intake 
rather than to a supplementary relationship between the 
proteins, and that results of feeding maize proteins with 
wheat gluten are of particular interest because of their 
effect in promoting growth, despite the relatively low 
lysine content of both wheat and maize proteins. 

Through further experiments these investigators have 
found that gelatin supplements the protein of oats (lack- 
ing in lysine), but that zein (the protein of maize) also 
supplements the protein of oats, although zein is lacking 
in tryptophane and lysine and is one of the poorest in 
cystine, — and furthermore that gelatin does not supple- 
ment maize. 

If gelatin supplements oats, then it should supplement 
maize, which it does not, and if gelatin supplements oats, 

6 Arch. Pediat., July, 1921. 
1 J. Biol. Chem., Jan., 1917. 



108 NUTRITION AND SPECIFIC THERAPY 

then zein should not, and it does, — that is, if the amino- 
acid lysine is the determining factor. 

These research men conclude that in the protein of oats, 
therefore, these amino-acids are eliminated as being pos- 
sibly the essential amino-acids determining growth. 

The author ventures the suggestion that perhaps the 
fat-soluble A vitamine, or the water-soluble B vitamine 
combined with the necessary supply of mineral matter, is 
the determining factor in these experiments, although it 
is unquestionably admitted that a balanced amino-acid 
ration is necessary for growth. However, the argument 
is interesting, if not convincing, and points to many future 
researches along this line. 

Referring to Dr. Holt's criticism of vegetable proteins 
given above, the difference between animal and vegetable 
protein has been explained in Chapters I and III, and it 
is true that animal proteins are richer in amino-acids and 
more completely absorbed. But the author cannot con- 
clude vegetable proteins might be sufficient for mainte- 
nance, but not for growth, for vegetable proteins contain 
all the amino-acids found in animal proteins, only in 
smaller proportions. It is, therefore, only necessary to 
allow more vegetable than animal protein in the diet to 
make up the deficiency for growing children, emphasizing 
that it be obtained from a variety of vegetable proteins 
to insure securing the adequate amount of each amino- 
acid. (Chapter VI, Sixteen Rules.) 

The author also would not sanction giving two or three 
times as much protein in cow's milk as is found in woman's 
milk. This might give the required amount of lysine, or 
cystine, or other necessary amino-acids, but would also give 
far too great a proportion of many other amino-acids. 
Excellent results have been obtained, in the case of young 
infants, from cow's milk that contained the same amount 
of protein as woman's milk, combined, however, with 
cereal gruels, vegetable purees, thin potato and carrot 



INFANTS' DIETS; CHILDREN'S DIETS 109 

purees, a small amount of yolk of egg (at the third month) 
and fruit juices. In some cases that do not gain, a small 
additional quantity of skimmed milk might be added to 
the formulas given in this chapter, reducing the sugar, 
or in place of some of the cereal water, using of course the 
given quantity of whole milk in each formula as the basis 
of the modification. (See page 100, Egg Yolk.) 

Dr. Holt, while being a firm believer in a high protein 
diet in the case of cow's milk for infants, lays much blame, 
in cases of acute intestinal disturbances, to carbohydrates, 
especially the sugars, and in conclusion states that more 
fat and protein can be tolerated if the sugar is low. 

These variations from the modifications given further 
in the chapter may prove beneficial in certain cases. 

This argument certainly bears significance, and it is the 
author's opinion that some other foods should always be 
given in connection with cow's milk, such as ripe fruit 
juices, vegetable juices and cereal waters when the infant 
is very young, and also thin legume gruels (strained) and 
some egg yolk when the infant is three months old. These 
should be tried one at a time, and in very small amounts 
which should be increased to several teaspoons if digestion 
permits. A teaspoon of egg yolk every day may prove 
valuable for the amino-acids of the protein, for the lecithin 
lacking in cow's milk and for a better balanced mineral 
ration than is found in cow's milk for the infant. In other 
words, quality is as important as quantity in the food 
principles. 

The orange juice or substitute (Chapter IX) should be 
strained through muslin when the infant is very young. 
Two teaspoons a day in connection with sterilized milk 
may be given to a newborn infant, and this amount should 
be increased each month until at 9 months the infant is 
receiving 4-5 tablespoons of orange juice or substitute. 

Dr. Joseph Brennemann 8 of Chicago has done some 

6 Arch. Pediat., Feb., 1917. 



110 NUTRITION AND SPECIFIC THERAPY 

verv interesting work in connection with the digestion of 
raw, pasteurized and sterilized milk. He was fortunate 
in securing the willing services of a man in whom the 
vomiting reflex was readily elicited by digital irritation of 
the fauces. The following results were obtained from his 
experiments : — 

In the stomach the size of the curds of raw milk are some- 
times two inches long and one inch thick and they are often 
hard and as large as a walnut. But if the milk is sterilized, 
the curds are reduced to the size of a pea and many of the 
curds are like sand, and the general consistency is very dif- 
ferent from the hard and rubbery curd of raw milk. 

The curds of pasteurized milk in the stomach are much 
like that of raw milk. 

Even after five hours, the hard curds of raw milk are still 
found in the stomach. Mucus is found very abundantly, 
especially after the first half hour and the curds are slippery 
and covered with mucus, and more or less bound together by 
it. At the end of a half hour, the stomach contents are 
neither offensive nor bitter. But after one hour, and even 
more marked after two or more hours, they have a very offen- 
sive, sour, fatty acid odor. 

In sterilized milk, the whey is less definitely separated 
from the curd. 

The less the proportion of fat in the milk, the harder and 
larger are the curds in the stomach; the greater the amount 
of fat, the longer the milk remains in the stomach and the 
slower the digestion. 

Milk taken very slowly forms a larger curd than when 
taken rapidly. This is a startling conclusion, but the ex- 
planation probably lies in the fact that all the casein has 
coagulated in a few curds so large that they cannot be re- 
turned, for five hours later the curds have been digested to a 
returnable size. 

The greater the dilution with water, the finer are the curds 
in the stomach. 

Alkalies and sodium salts very greatly inhibit coagulation, 
even may stop it completely if in sufficient amounts. 



INFANTS 5 DIETS; CHILDREN'S DIETS 111 

Precoagulated milk such as buttermilk, pegnin milk or 
eiweissmilch (Finkelstein) shows very little tendency to re- 
coagulation. 

Dried and condensed milks as a rule form a medium curd. 
Starchy decoctions such as barley water have a very decided 
influence in lessening the size of the curd, much more than 
a simple watery dilution. 

Soluble carbohydrates such as dextrins and sugars (milk, 
cane or malt sugar) have apparently no appreciable influence 
on the curd. 

Dr. Brennemann said that after having used raw and 
sterilized milk each for many years, there was no doubt in 
his mind that infants are in general harder to feed on raw 
milk than on sterilized milk, and that the explanation is 
a physiological rather than a bacteriological one. Raw 
milk is only in appearance a liquid food. Milk in the 
stomach must contain finely divided curds in the case of 
infants. All the therapeutic measures that aim to adapt 
cow's milk to the baby have one thing in common, and that 
is to make the large, hard curd more like the small, soft 
curd of mother's milk. This is the aim in diluted, boiled, 
pasteurized, condensed, dried, malted, precoagulated by 
acids or rennin, alkalinized, citrated, whey milks, etc. 

Straight milk can be given much earlier when boiled. 
Commercial pasteurization is not reliable, and pasteuriza- 
tion at home has many difficulties, and only partly solves 
the bacteriological problem, while the physiological re- 
mains unsolved for the most part. 

Although sterilization of milk, with the addition of 
orange juice, solves the most difficult problems in connec- 
tion with bottle-fed infants, this should not minimize the 
necessity for procuring clean milk in the beginning. All 
milk should be as free from filth as possible before steri- 
lization, and this is best accomplished by centrifugally 
cleansing it of the udder wastes, and other foreign and 
impure substances it may contain. Most milk is contami- 



112 NUTRITION AND SPECIFIC THERAPY 

nated with particles of dust, manure, hair, insects, etc. 
Some of these float on the surface, while others settle to 
the bottom. Udder waste, pus and bacteria, together with 
the greater part of the dirt, are thrown out by the applica- 
tion of centrifugal force, and come out as a slimy mass. 

The following points 9 concerning centrifuged milk are 
briefly outlined : — 

1. The insoluble dirt is effectively removed. 

2. Cellular elements are removed to a large degree. 

3. Bacteria are removed in varying amounts, the larger 
more readily than the smaller. 

4. Clarified milk trends more closely towards typical 
lactic acid fermentation, while unclarified milk will 
manifest obnoxious signs. 

5. Unclarified milk develops molds in abundance and 
putrid decomposition. 

6. Carbon dioxide develops in abundance in clarified 
milk. 

7. Obnoxious odors are detected in unclarified milk. 

Raw milk causes a large percentage of infant deaths 
from intestinal diseases ; it often is the cause of septic sore 
throat, typhoid fever, scarlet fever, tuberculosis and diph- 
theria. Certified milk cannot furnish a guarantee, for not 
only has tuberculosis constantly been found in the cows of 
certified herds to some extent, but sometimes to a large 
extent. It is always difficult to keep cows free from udder 
disease, and sore udders contaminating the milk with 
streptococci, are dangerous as the cause of septic sore 
throat. 

The following rules are those that in the author's expe- 
rience have produced excellent results in the case of the 
average normal infant : — 

The modification naturally changes with the individual 
infant, and with the age of the infant. Some infants re- 

•C. E. Marshall, Am. J. Pub. Health, Feb., 1920. 



INFANTS' DIETS; CHILDREN'S DIETS 113 

quire a different proportion of protein, others a different 
amount of fat, and still others a greater or less amount of 
sugar. These facts must be determined by the digestion 
of each particular infant. The following symptoms will 
serve as somewhat of a guide : — 

Emphasis must be given not to feed an infant too often 
or too fast, since both induce physical disorder. Twenty 
minutes is none too long for each feeding. 

If the infant is overfeeding, regurgitation and vomiting 
result, and sometimes diarrhea and colic. Vomiting is 
also caused by fast feeding and the swallowing of air. 

Too much fat in the milk produces vomiting, regurgita- 
tion, an acid stomach and constipation or perhaps diar- 
rhea. In this case, either reduce the fat or try olive oil 
(1 teaspoon or less to every four ounces of whole milk 
used in the author's modification). There generally is 
much mucus in the stools if the fat has not been well 
tolerated, and they are formed, and of a light color. Some- 
times fat stools are granular. 

F. Friedberg and C. JSToeggerath 10 describe the remark- 
able improvement of certain very sick infants when fed 
with breast milk from which the fat has been removed by 
centrifuging, especially in cases of decomposition, as well 
as ordinary toxicosis, the length of time this is fed depend- 
ing upon the infant. 

Too great a proportion of protein in the milk may pro- 
duce colic, vomiting, curds and much mucus in the stools. 
The stools are semiformed and often watery. Sometimes 
the color is olive green with a glossy aspect. There may 
be alternating constipation and diarrhea. In this case 
use less milk in the modification and more cereal water 
with perhaps a little more cream, sugar or egg yolk. 

Carbohydrate stools are easier to detect. They are read- 
ily stained with dilute tincture of iodin, the particles of 
undigested starch staining blue or black. The stools are 

10 Arch. Pediat., Oct., 1921. 



114 NUTRITION AND SPECIFIC THERAPY 

loose, acid in reaction, and light brown, excoriating and 
contain much mucus, indicating undigested cereals. 

In this case, try different cereals, or less cereal, adding 
a little more sugar to the mixture. 

Indigestion of sugar produces frequent, excoriating, 
watery and very acid stools. They are green if sucrose or 
lactose has been used in the modification, and brown if 
maltose has been used. There may be much gas and flatu- 
lence as a result of the fermentation of the sugar. 

In this case use a different sugar in the modification 
(lactose or maltose) and if there is then no improvement, 
reduce the sugar, or possibly reduce it with the addition of 
a little more cream or whole milk in the mixture; or use 
protein milk which may be made by heating and precipi- 
tating the casein in a quart of fat-free milk by essence 
of pepsin or rennin ; the resulting curd is rubbed through 
a sieve with enough water to make one pint. (See also 
Infants' Diarrhea, Chapter VII.) 

Dr. John Howland rl says, — in prolonged intolerance 
of carbohydrate, protein milk should be advocated, and 
continued until the stools are firm, distention is very slight, 
gas is not in excess, and the appetite is good. 

The foregoing symptoms indicate that the problem of 
feeding a bottle-fed infant is one that should demand the 
greatest care and attention. The number of stools, their 
consistency, color and the presence of mucus and blood are 
all of great significance in relation to the health of the 
infant. (For further details, 12 see article by Joseph I. 
Grover of Harvard University.) 

Breast-fed infants have from two to four stools a day, 
while bottle-fed infants have from one to two, and may 
often skip a day if a laxative is not given. This should 
be avoided in every case possible. If constipation is pres- 
ent, but otherwise the infant seems in good health, give 

n Arch. Pediat., July, 1921. 
13 J. A. M. A., Feb., 1921. 



INFANTS' DIETS; CHILDREN'S DIETS 115 

more orange juice. If this does not remedy the case, 
change the milk modification, using perhaps less fat and 
more milk or sugar, or less fat and less milk and more 
sugar and cereal gruel or puree. (See Chapter X.) 

Evaporated, condensed and malted milks have been in 
vogue for many years, but they should be regarded as 
very questionable and used only when better products are 
not obtainable. They may produce many physical dis- 
orders. 

In some cases, however, malt soup extracts (a different 
product from malted milks) may be highly recommended. 
They have the disadvantage of being high in price, but in 
difficult cases of diarrhea and constipation with loss of 
weight, they have often given excellent results. 

The use of malt soup extract dates back many years to 
the days of Von Liebig who first used it for normal infants 
deprived of mother's milk. His original formula has been 
abandoned and that by Keller is used to-day for infants 
suffering from intestinal disorders, either constipation or 
diarrhea. The directions come with the preparations. 
It has been employed perhaps more in cases of diarrhea, 
but is coming to be used more extensively in cases of con- 
stipation. Naturally the same formula could not be used 
in both cases, and so it is modified to counteract either con- 
stipation or diarrhea. 

Malt soup extract contains 50 to 70 per cent maltose, 
5 to 15 per cent dextrin, 5 to 12 per cent soluble protein, 
20 to 25 per cent water, and small amounts of potassium 
carbonate, phosphoric and lactic acids, etc. 

Maltose is quickly absorbed and better tolerated than 
lactose or cane sugar if an infant does not tolerate sugar 
well. Potassium carbonate is used because human milk 
contains this in a larger amount than it does the other 
salts, and because it is probably the alkali that combines 
principally with acids in acid intoxication which is often 
the case where milks have not agreed. 



116 NUTRITION AND SPECIFIC THERAPY 

In the preparation of the food, wheat water is generally- 
used because it ferments less readily with the maltose than 
the other grains ; and any cereal water prevents mechani- 
cally the formation of tough curds. Oats is used in cases 
of constipation. Boiled, whole milk is added to the prepa- 
ration. 

The presence of potassium carbonate produces good re- 
sults in the correction of constipation. It has been shown 
by Holt that loose stools contain. a larger proportion of 
potassium and sodium than constipated stools. 

An infant should be started on a weak formula, pre- 
ceded by starvation and purgation. A case that does well 
will have no vomiting and will gain weight. If the infant 
vomits, and this is not controlled by limiting the amount 
or by giving a weaker formula, or if the infant has loose 
stools with much mucus, and they give a blue starch reac- 
tion to iodin, this food should be discontinued. A little 
vomiting may be permitted if the infant is gaining. If 
the infant retains this food, is not constipated, and does 
not gain in weight, increase the malt soup extract. 

From the foregoing discussion, it is clearly seen that, 
while malt soup extract is a valuable food in certain diffi- 
cult cases of infant feeding, there is no hard and fast rule 
concerning its preparation. The directions that come with 
the preparation must be varied to suit the individual cases. 
The food should be prepared the same as any other, mak- 
ing enough each time for twenty-four hours' use, and bot- 
tling it in as many bottles as there are to be feedings a day. 

The following formulas by A. G. Mitchell of Philadel- 
phia will serve as a guide in the use of malt soup extract : — 

In the preparation of the soup itself, the amount of flour 
ordered should be mixed with a small amount of water to 
make a paste, the rest of the water ordered is added, and 
this is boiled for twenty minutes. Then the amount of malt 
soup extract ordered is mixed with this starch and water 
solution, constantly stirring. The milk ordered should then 



INFANTS' DIETS; CHILDREN'S DIETS 117 

be added, and the whole brought to a boil again. Water is 
added to bring up the amount lost in boiling. 

In Dr. Mitchell's 13 work at The Children's Hospital 
he has used several different formulas which have been 
found convenient in increasing the percentages. These, 
with the approximate percentages of fat, carbohydrate and 
protein are given as follows : — 

(Use unrefined cereal flour. — Author.) 
Formula A — y 2 ounce wheat flour 
10 ounces skimmed milk 
10 ounces water 
1 ounce malt extract 
Fat, 0.2 per cent.; carbohydrate, 7.5 per cent, (of which 
2 per cent, is starch) ; protein, 2.2 per cent. 

Formula B — y 2 ounce wheat flour 
5 ounces skimmed milk 
5 ounces whole milk 
10 ounces water 
1 ounce malt extract 
Fat, 0.2 per cent.; carbohydrate, 7.5 per cent, (of which 
2 per cent, is starch) ; protein, 2.2 per cent. 

Formula C — % ounce wheat flour 
10 ounces whole milk 
10 ounces water 
1 ounce malt extract 
Fat, 2 per cent.; carbohydrate, 7.5 per cent, (of which 
2 per cent, is starch) ; protein, 2.2 per cent. 

Formula D — 1 ounce wheat flour 
10 ounces whole milk 
10 ounces water 
iy 2 ounces malt extract 
Fat, 2 per cent. ; carbohydrate, 14 per cent, (of which 5.7 
per cent, is starch) ; protein, 2.9 per cent. 
13 Arch. Pediat., Jan., 1916. 



118 NUTRITION AND SPECIFIC THERAPY 

These formulas made with any extract of malt would 
give about the same percentages. 

Barley flour may be used instead of wheat flour in cases 
of diarrhea. Wheat flour is probably better because the 
combination of wheat flour and malt extract is least apt 
to ferment, and produces the smallest amount of acids. 

Using the proportions given in these formulas, make 
up the correct amount of ounces for the twenty-four hours' 
feeding, and apply to the hour schedule. In other words, 
make up about one-half again as much for the first and 
second months' feedings. For example, add % ounce 
wheat flour, 5 ounces skimmed milk, 5 ounces water and 
% ounce malt extract to Formula A. After the second 
month make up about two times any of the formulas. The 
correct amount of ounces according to age, and the hour 
schedule are given under the modification generally used 
by the author. 

The reason for choosing this modification is as follows : 

Human milk contains: 

Protein 1.5 per cent. 

Fat 3.5 " " 

Carbohydrate 6.5 " " 

Mineral Matter 2 " " 

Cow's milk contains : 

Protein 3.5 per cent. 

Fat 4.0 " " 

Carbohydrate 4.5 " " 

Mineral Matter 7 " " 

Cereal water contains : 

Protein 05 per cent. 

Fat .051 " " 
Carbohydrate '!.".!.".!!.'!!.". &9 " " 
Mineral Matter 015 " " 

This percentage composition of cereal water is obtained 
using the proportion of 2 tablespoons of flour to 20 ounces 
of water. 



INFANTS' DIETS; CHILDREN'S DIETS 119 

By mixing equal quantities of whole cow's milk and 
cereal water, the average per cent will be : 

Protein 1.8 

Fat 2.0 

Carbohydrate 3.8 

Mineral Matter 35 

This makes the proportion of protein about right, but 
leaves the fat and sugar too low, while the mineral matter 
is too high. To remedy this lack in fat and sugar, add to 
every four ounces of the milk, 2 teaspoons of cream, and 
to every four ounces of the cereal water 2 teaspoons of 
lactose or maltose, or dextri-maltose. 

The resulting mixture is about right, except for a small 
excess of mineral matter. This defect may be overcome 
by a very small amount of lime water, although it is the 
author's opinion that too much lime water is generally 
used, and it might be well to omit it almost entirely when 
sterilized milk is employed. While the addition of lime 
water would seem to tend to increase the mineral content 
of the mixture, it nevertheless has the opposite effect in 
relation to absorption, by changing part of the calcium 
and phosphorus already present in cow's milk from a 
soluble to an insoluble form. Through this change, the 
clot in the stomach is made less dense, — this is the purpose 
of the lime water. But sterilization accomplishes this 
aim also, and it does not have the questionable result pro- 
duced by the addition of the lime water of perhaps reduc- 
ing the amount of soluble calcium and phosphorus in cow's 
milk to a point below that in human milk. 

This problem 14 has been discussed by H. I. Bowditch 
and A. W. Bosworth through experiments conducted in 
Boston. An infant requires .18 grams of calcium daily 
(Schabad). One of the striking differences brought out 
in comparing cow's milk with human milk is in the amount 
14 Boston M. & 8. J., Dec, 1917; J. Biol. Chem., Jan., 1917. 



120 NUTRITION AND SPECIFIC THERAPY 

of insoluble, inorganic calcium and phosphorus. There 
is only a small amount of this in human milk, but a large 
amount in cow's milk, in the form of insoluble, dicalcium 
phosphate. It has been found that children over four 
months can utilize some of this, while younger ones can- 
not. There is also much soluble calcium and phosphorus 



Q COW ? S 



milk. 



This fact has special significance in connection with 
the addition of lime water to cow's milk, as the addition 
of the lime water results in the precipitation of insoluble, 
dicalcium phosphate : — 

CaCl 2 + 2NaH 2 P0 4 + Ca(OH) 2 = 2NaCl + 
2CaHP0 4 + 2H 2 

Therefore it is possible by the addition of lime water 
to reduce the soluble calcium and phosphorus in modified 
mixtures to amounts less than those in human milk, which 
contains these for the most part in an easily assimilable 
organic form. This fact may have a bearing upon certain 
abnormalities found in infant feeding. 

In discussing 15 the possible effect of the addition of 
lime water to infant's food, it is interesting to note the 
results of some investigations by Dr. Alfred Hess and Dr. 
Lester J. Unger of New York who have conducted experi- 
ments to a very large extent in infants' foods. In a recent 
article they speak of the deleterious effect of the alka- 
lization of modified milk. Orange juice, the prototype of 
antiscorbutics, is damaged within 24 hours through being 
rendered twentieth normal alkaline to phenolphthalein. It 
is evident, therefore, that the antiscorbutic vitamine is pe- 
culiarly sensitive to alkalization, more so than the fat- 
soluble A and the water-soluble B vitamine. 

Doctors Hess and Unger cite the following case: — An 
infant was fed on malt soup extract with cereal water and 
"J. Biol. Chem., March, 1919. 



INFANTS' DIETS; CHILDREN'S DIETS 121 

cod liver oil (rich in vit amine A) and had not been gain- 
ing in weight ; the potassium carbonate in the formula was 
discontinued with the result of an immediate gain in 
weight. Therefore, there is a question as to the amount 
of potassium carbonate to be used in malt soup prepara- 
tions. This salt is used in many proprietary foods for 
infants because it renders the food less subject to acid 
fermentation, and because it counterbalances the relative 
poverty of this salt in cow's milk. 

Feeding top milk also has produced many evil effects in 
the author's opinion. Milk should be thoroughly shaken 
before the correct amount is measured. John Lovett 
Morse has given some wise counsel on this subject. He 
asks why physicians have advised top milk and gives the 
following reasons: — "Many physicians have unintention- 
ally disregarded the teachings of those who have known 
how to use fat; the erroneous idea prevalent years ago, 
and long since discarded, that fat cannot do any harm to 
an infant ; the knowledge of the fact that fat may act as a 
laxative, and the ignorance of the fact that it may consti- 
pate ; the desire to make the infant gain ; the carelessness 
of physicians in directing mothers how to prepare the 
food ; the laziness of physicians in that they will not take 
the trouble to learn how to modify milk properly." 

All questions considered, it is the author's opinion that 
sterilized, whole, certified milk, diluted with cereal water, 
with the addition of sterilized cream, milk or malt sugar, 
or dextri-maltose, and perhaps ^ ounce of lime water 
(about y 2 tablespoon to 30 ounces of the mixture) gives 
the most ideal modification for the normal infant. Orange 
juice should be combined with this daily, according to the 
age of the infant, and given between feedings. Soon other 
juices, and gruels, and egg yolk should be added. 

During the first 48 hours, the infant receives practically 
no nourishment, — about 6 ounces a day at intervals of six 



122 NUTRITION AND SPECIFIC THERAPY 

hours. It should be given a few teaspoons of warm, steri- 
lized water. On the third day the regular feedings begin, 
and the infant should be roused from sleep if necessary. 

During the first two months, the feedings should be be- 
tween one and two, and four and five in the night, but after 
that, it will require but one night feeding, and after five 
months, no night feeding. 

One to two ounces of sterilized warm water should be 
given each day to a nursing infant, and three to four 
ounces, three times a day, should be given a child a year 
old. The water can be given cool after the third month 
if it is better relished. 

Approximate Gain in Weight, First Year (Crozer and Griffith) 

First Month 7 oz. a week 

Third and Fourth Month 5V 2 " " " 

Fifth and Sixth Month 4% " " " 

Eemainder of the Year 3% " " " 

An infant generally loses in weight up to the third or 
fourth day, and may not regain its original weight until 
the fourteenth day. 

Milk Modification. — The following steps are necessary 
in any properly prepared modification. 

1. Pure, fresh milk' from a healthy cow or herd should 
be used. It should be kept in the original bottles 
on ice until the food is prepared, just before which 
the bottles should be well shaken to mix the top and 
bottom milk. 

There should be as many nursing bottles as the 
infant is to be fed times a day, standing the bottles 
in a wire rack until used. 

2. Pour entire quantity of milk into a sterilized pitcher, 
and from this take the quantity advised in each 
formula according to the age of the child. Entire 
quantity for the twenty-four hours should be pre- 
pared at once. If possible, use a glass graduate for 



INFANTS' DIETS; CHILDREN'S DIETS 123 

measuring in ounces. (2 level tablespoons = one 
ounce, is a reliable measure for small amounts.) 

3. Mix required amount of cereal flour, barley, wheat or 
oats, using oats if the infant is constipated, about two 
level tablespoons with a little cold water and a pinch 
of salt, until the seventh month, — after this double 
the proportion of cereal flour. 

4. Stir cereal paste into 20 ounces of hot water and 
cook in a double boiler 20 minutes; add enough 
water to make 20 ounces when finished. 

5. Pour gruel into a sterilized pitcher. Add the milk 
or malt sugar (2 level teaspoons to every 4 ounces), 
and stir. (Use one-third to one-half this amount of 
cane sugar if other sugars are not available.) 

6. Stand pitcher in cold water until the gruel is 98° 
Fahrenheit. 

7. Take required amount of whole milk while the gruel 
is cooling, the cream having been added (2 teaspoons 
to every four ounces) to the milk before it was steri- 
lized. 

8. Measure correct amount of lime water (^4 ounce up 
to the seventh month) and add to the milk. 

9. Strain the gruel, pour it into the milk and stir. 

10. Pour this modified milk into bottles needed for the 
24 hours. 

11. Cork bottles firmly with twisted wads of sterilized 
cotton or white waxed paper fastened on with a 
rubber band. 

12. Cool the bottles by standing the rack in a pan of 
cold water. 

13. Place rack in the ice-box. 

14. Stand bottles in hot water before each feeding until 
the milk is 98° Fahrenheit. 

15. Remove cotton or paper, adjust nipple, invert bottle, 
and test heat of milk on the wrist. (It should be 
body temperature.) 



12i NUTRITION AND SPECIFIC THERAPY 

16. Put on woolen bag to keep milk warm, and serve at 
once. 

Care of Bottles and Nipples. — Always boil a new nipple 
for five minutes. After using, rinse it in cold water. 
Each day turn nipples inside out and scrub with warm 
water and soap and rinse. Keep in a covered cup of borax 
water. Have as many nipples as bottles. 

Immediately after using, rinse bottle in cold water. 
Wash all bottles for 24 hours' use in hot, soapy water with 
a bottle brush. Rinse bottles in hot water and boil for 
twenty minutes. Nipples may be boiled with the bottles 
as a further precaution. Keep bottles inverted in a wire 
rack until used. 

Olive oil referred to previously in this chapter may be 
tried in place of the cream if a fat intolerance exists, 
always using about one-half as much as the amount of 
cream called for. 

If milk or malt sugar are not available, use only one- 
third to one-half as much cane sugar as milk or malt sugar 
called for in each formula. Maltose sometimes has too 
great a laxative effect. Dextri-maltose, generally made 
from potato-starch, is much cheaper, and, therefore, rec- 
ommended more for general use. 

The orange juice should always be given between feed- 
ings, and diluted with boiled water if sour. At the third 
month it may be advisable to give also juices from the 
potato, tomato, carrots, lettuce, a teaspoon of egg yolk, and 
a few teaspoons of legume gruels. 

First Month 

Milk 15 ounces 

Cereal Water 15 ounces 

Maltose or Lactose IV2 level teaspoons 

Cream 7% teaspoons 

Lime Water % ounce (% tablespoon) 

Orange Juice 2 teaspoons a day 



INFANTS' DIETS; CHILDREN'S DIETS 125 

One to two night feedings. 

Give 3-4 ounces for 7 feedings depending upon the indi- 
vidual child. (Some authorities advise only 6 feedings.) 

Second Month 

Milk 15 ounces 

Cereal Water 15 ounces 

Maltose or Lactose 7% teaspoons (3 level tablespoons) 

Cream 7y 2 teaspoons (3 " " ) 

Lime Water %, ounce 

Orange Juice 3 teaspoons a day 

One to two night feedings. 
Give 4 ounces for 7 feedings. 

Third and Fourth Months 

(Other foods previously stated may be added.) 

Milk 18 ounces 

Cereal Water 18 ounces 

Maltose or Lactose 9 teaspoons (3 level tablespoons) 

Cream 9 teaspoons (3 " ) 

Lime Water % ounce 

Orange Juice 4^2~6 teaspoons a day 

Give 4-5 ounces for 7 feedings. 
One night feeding. 

Fifth and Sixth Months 

Milk 18 ounces 

Cereal Water 18 ounces 

Maltose or Lactose 9 teaspoons (3 level tablespoons) 

Cream 9 teaspoons (3 " " ) 

Lime Water V^ ounce 

Orange Juice 7*/2~9 teaspoons a day (3 table- 
spoons) 

Give 6-7 ounces for 5 feedings. 
No night feeding. 

Seventh, Eighth and Ninth Months 

Double the strength of the cereal water. Gradually 
accustom the child to other foods, such as lettuce and car- 
rot puree, potato puree, soft egg yolk and soft, ripe pulp 



126 NUTRITION AND SPECIFIC THERAPY 

of raw peaches and pears, and stewed prunes and baked 
apples, if these foods have not already been given. 

Milk 20 ounces 

Cereal Water 20 ounces 

Maltose or Lactose 10 teaspoons (3% tablespoons) 

Cream 10 teaspoons (3% ) 

Lime Water % ounce 

Orange Juice lO 1 /^-^ 1 /^ teaspoons a day (About 

4-5 tablespoons) 

Give 8 ounces for 5 feedings. 

Tenth, Eleventh and Twelfth Months 

At this age the infant may be weaned. If it is breast 
fed and doing well, it may be best not to wean an infant 
until it is a year old. Gradually withdraw either mother's 
or cow's milk, adding only one new food at a time, allow- 
ing enough time between each new food to test the merits 
of each for the particular infant in question. If a certain 
vegetable, fruit, potato, egg, etc., does not agree, try an- 
other, for each child is a different problem. 

Milk 20 ounces 

Cereal Water 20 ounces 

Maltose or Lactose 10 teaspoons (3% tablespoons) 

Cream 10 teaspoons (3% ) 

Lime Water V2 ounce 

Orange Juice 5~6 tablespoons a day 

Give 10 ounces for 4 feedings. 

Many formulas for the modification of milk are very 
different from those given above. For instance, some have 
a much larger proportion of cereal water than milk during 
the early months, and generally one ounce of lime water 
is added. As the infant grows older, the milk is grad- 
ually increased until it is in a proportion considerably 
larger than the cereal water. In some cases these formu- 
las might be better, but they do not resemble mother's milk 
in the percentage of the food principles. A larger amount 



INFANTS' DIETS; CHILDREN'S DIETS 127 

of milk may be advisable in some cases in which there 
is not the normal gain. In these cases a reduction in the 
sugar may be advisable. 

Diet for a Child One Year Old. — The diet recommended 
by the author for a child one year old is different from 
that found in the majority of books on this subject. The 
main difference centers around the elimination of cow's 
milk as far as possible, other foods furnishing the same 
nutritive requirements being selected in its place. This 
is a radical change, and one that is attempted with con- 
siderable misapprehension by physicians and mothers. 
However, if the child is normal, and the foods are chosen 
with a scientific knowledge, the fears are unfounded, and 
the child is benefited. The bacterial and dirt problem of 
cow's milk is solved in its elimination from the diet, and if 
the child is inclined toward constipation, this problem is 
also solved. Why do physicians insist on advising an 
abundant supply of cow's milk to all weaned children, a 
food suited primarily by nature for the nourishment of 
the calf, when dozens of other foods in proper combina- 
tion have every advantage of cow's milk and none of the 
disadvantages ? We read, "No child should receive less 
than a pint of milk a day." The milk question is univer- 
sally considered a serious one, and every day literature 
and text-books are filled with its problems. 

M. J. Kosenau has written a book of about three hun- 
dred pages on the problems of this food. He asks, — "Why 
do we have a milk question?" He answers the question 
by saying that "milk is apt to be dangerous to health," — 
and that "we cannot do without milk." He further states 
that "it is the most difficult of all our standard articles of 
diet to obtain, and handle in a safe and sanitary manner. 
Milk decomposes more quickly than any other food. It is 
probably accountable for more sickness and more deaths 
than all other foods put together. There probably is no 
single problem in the whole realm of modern sanitation 



128 NUTRITION AND SPECIFIC THERAPY 

and hygiene that is so complex, so involved, so intricate 
and so harassing." 

The author admits that this question is more or less 
difficult in the feeding of children whose parents have no 
knowledge of the chemistry of foods, and their digestion, 
and the requirements of the healthy body. But this fact 
is what has been lamented elsewhere in this little volume, 
for this knowledge should be a requirement, and not omit- 
ted or optional, in the education of every young man and 
woman. If milk is responsible for more sickness and 
deaths than all other foods combined, surely it should be 
eliminated from the diet after the nursing period, — and 
if used at all, it should be sterilized. There is not the 
slightest question that substitutes for milk can be used 
in the diet after the nursing period, but custom and habit 
are such dominant factors in the daily life of man that it 
is well-nigh impossible to omit milk from the diet for 
children and adults. 

W. W. Cadbury, 16 of Canton, China, writes that "milk, 
butter and cheese are rarely used in China, — children 
grow strong without milk. Rachitis practically is never 
seen. When an infant is weaned he is given rice gruel." 

In eliminating milk from the diet after the nursing pe- 
riod, the author would not recommend so limited a diet 
as that on which the Chinese children are raised. Variety 
of the right kind of foods is a safeguard against all dis- 
eases, but the fact remains, nevertheless, that the Chinese 
children have been raised for centuries on a very limited 
diet with the exclusion of milk. 

The question is often asked, — why does a person who 
has been put on a milk diet because of a "run-down condi- 
tion" gain ? Such a person probably has been on a meat 
and high protein diet, and a change from this always would 
prove beneficial. Should this same person be put on a diet 
consisting of the legumes, cereals and nuts as the protein 

18 Am. J. Dis. Child., Jan., 1920. 



INFANTS' DIETS; CHILDREN'S DIETS 129 

foods, combined with tubers, raw fruits and vegetables, 
the benefits would probably be even more pronounced. 
(See Milk, Chapter III.) 

In discussing the value of milk for children, especially 
in connection with cereals, one writer makes the following 
statement : — 

Cereals produce phosphoric and sulphuric acids in diges- 
tion, and these must be neutralized or an acidosis will re- 
sult. Milk, which contains a large quantity of lime, is 
most valuable for neutralizing the acids produced from the 
cereals. 

Such an argument fails to convince, because protein is 
absolutely necessary for life and almost every protein con- 
tains sulphur and many of our most valuable foods con- 
tain phosphorus including milk itself. Milk contains much 
lime, but fruits and vegetables also contain much lime, 
and as has been explained, should be relied upon for their 
mineral content and neutralizing power. Milk has the 
many disadvantages already enumerated, while fruits and 
vegetables possess none of these. The author of the above 
remarks seems to be unmindful of these important facts. 
(See Calcium and Carrots, Chapter II; Milk, Chapter 

IIL ) 

A very excellent dish for either children or adults is 
some cereal, to which has been added a fresh fruit, — 
oranges, berries, etc., or dates, stewed prunes, raisins, etc. 

The majority of books on this subject also advise against 
short periods of cooking of cereals and vegetables, and lay 
emphasis on prolonged and thorough cooking of the 
starches. This the author has also found to be unnecessary. 
Instead of cooking cereals one to three hours, cook them 
perhaps one-half hour or as long as necessary to soften 
them sufficiently to rub through a very fine puree sieve for 
the child one year old. (See Chapter II.) 

Short periods of cooking starches sometimes produce a 
slightly laxative effect because of the fact that less of the 



130 NUTRITION AND SPECIFIC THERAPY 

starch is assimilated, and as a result lactic acid may be 
produced from it in the colon, but this is to be desired 
unless the symptom is too pronounced. Short periods of 
cooking the cellulose of cereals and vegetables may also 
produce the same effect. ( See Chapter II. ) If the laxa- 
tive effect is too pronounced, longer periods of cooking 
may then prove beneficial, but two to three movements 
a day are beneficial if not too loose. 

If the diet of fruit juices, thin purees of succulent vege- 
tables, unrefined cereal gruels, thin legume purees, roots 
and tubers, and soft boiled eggs proves a too laxative diet 
for a particular child of this age, then sterilized, certified 
milk can be given for such a period as this symptom of 
the child demands. 

Again, almost every authority advises the giving of meat 
broths and meats. According to the author's conviction 
it is a great mistake to give these foods to young children 
whose glands of internal secretions are undeveloped, which 
aid in destroying the bacterial poisons generated in the 
intestines, and which are absorbed and circulate through 
the entire system. 

Meat broths are not only food for bacteria in the in- 
testines, but they are worthless as far as the question of 
any nourishment is concerned. This is contrary to the ac- 
cepted idea. They are practically nothing but water 
laden with waste products, — urea, uric acid, xanthine, 
creatine, creatinine, etc., and a very small amount of salts 
and gelatin. Some of the nourishment has been drained 
off in the blood, and the muscle fiber and other proteins 
which furnish nutriment are not present in broth. The 
very small percentage of mineral matter and protein in 
meat broths can be supplied far better in many other foods. 

The following diets for children, one to four years old, 
have given excellent results in the author's experience. 

Let it be emphasized in the beginning that thirst should 
not be mistaken for hunger. Care should be taken that 



INFANTS' DIETS; CHILDREN'S DIETS 131 

the child should receive an adequate amount of water daily. 

During the second year, a child may have four meals a 
day at four-hour intervals, and this schedule may be con- 
tinued up tc the fourth year. 

When weaned, children may be given the pulp and 
juices of succulent vegetables, such as those of lettuce, 
cauliflower, cabbage, tomatoes, and of the roots and tubers, 
— carrots, turnips and beets, — baked or boiled potato 
(peeled after cooked), cereal and legume purees very thin 
(these are thicker than cereal gruels), soft eggs, espe- 
cially the yolk two or three times a week, the ripe juices 
and soft pulp of fresh fruits such as those of oranges, 
peaches, pears and plums, the juice of lemons and pine- 
apple, sweetened with milk or malt sugar, the stewed pulp 
of prunes and apples, and the juices of berries. 

Never drain vegetables, cereals or legumes in their prep- 
aration. 

During the third year, it is not necessary to rub the 
vegetables, cereals and legumes through a puree sieve. 
The vegetables can be given chopped fine, the cereals can 
be given whole ; and the legume purees may be thicker. 
Dates and raisins cut up fine may be added, and peanut 
butter may be spread on toast (also advised at 18 months). 

If milk or cream is added to the menu, always give it 
sterilized, both for bacteriological and physiological rea- 
sons. 

During the fourth year, any of the foods recommended 
in this book may be given, taking into account the diges- 
tion of each particular child. 

Rules Worth Observing 

1. If a child refuses plain bread and butter between 
meals, give him nothing, for he is not hungry. 

2. Give little variety at a time. Generally too great 
a variety is given. 



132 NUTRITION AND SPECIFIC THERAPY 

3. Allow plenty of time for each meal. If a child plays 
with his food, remove it, and offer him no food until 
the next meal. 

4. Do not force a child to eat. Do not offer him sweets 
when simple food is refused. 

5. Teach him to chew his food thoroughly. 

6. Keep the child happy at meal time. 

7. Thirst is often mistaken for hunger. 

8. Little or no cane sugar is needed if the child receives 
the required amount of fruit juices, dates, prunes, 
and raisins, or perhaps honey. 

9. Do not give highly seasoned foods from the family 
dish. Serve the child's meal before the spices are 
added. 

10. Never give fried foods of any kind, hot breads, cakes, 
canned or preserved fruits. Graham crackers may 
sometimes satisfy the desire for sweets. 

• The following is a typical one day's food chart for a 
child during the second year : — 

6 a. m. — % cup oatmeal puree. 
10 A. M. — 1 tablespoons boiled carrots mashed through a 
puree sieve. (Vary this with any succulent veg- 
etable given above.) A pinch of salt and butter 
or olive oil may be added. % cup unrefined corn- 
meal puree. (Vary this with unrefined wheat 
and oats.) 

2 P. Mi. — Yolk of soft boiled egg every other day. Mashed, 
boiled or baked potato with a pinch of salt and a 
little butter or olive oil. When egg is not given, 
prepare a cup of pea or bean puree and serve with 
this y 2 cup of vegetables instead of the potato. 

6 P. M. — Pulp of baked apple, prunes or that of fresh ripe 
peaches, pears or plums, or the juices of berries. 
1 slice of oven dried toast. 



INFANTS' DIETS; CHILDREN'S DIETS 133 

There should be no constipation on this diet If there 
is a tendency towards diarrhea, some sterilized milk may 
be given instead of some of the legumes, and no fruit 
pulp, but fruit juices should be continued. Less vegetables 
and more potato may also prove beneficial to counteract 
this tendency. 

Children's Diet with Milk. — For those for whom it 
seems impossible to break away from the time-honored cus- 
tom of feeding children with cow's milk, the following 
day's food chart for a twelve months' child is given: — 

6 a. M. — 12 ounces sterilized whole milk. 

% slice oven dried toast. 
8 a. m. — % cup orange juice. 
10 a. M. — % cup oatmeal puree, and *4 cup boiled, mashed 

carrots ; or yolk of an egg, and a baked potato ; or 

pea puree and a vegetable. 
2. p. M. — 12 ounces sterilized, whole milk and % slice oven 

dried toast. 
6 p. M. — Cornmeal puree cooked in double boiler in 8 ounces 

milk; (% cup when cooked) a small amount of 

sugar and a pinch of salt may be added. 

% cup fruit juice. 

During the fourth year, breakfast may be given at 7 
a.m., orange juice at 10 :30 a.m., luncheon at 1 p.m., and 
dinner at 5 :30 p.m. 

At an early age, the majority of books recommend meats 
in many forms. In place of these the author recommends 
peas, beans and lentils, all cereals, especially whole grain 
wheat and oatmeal, eggs and nut butters, such as peanut 
butter and soy bean butter. (See Chapter X.) These 
foods should be combined with any of the vegetables, roots, 
tubers and fruits. The value of honey is again empha- 
sized. Cocoa may occasionally be given. 

If these dietaries for infants and children are carried 
out with thought, and a genuine desire for the child's wel- 



134 NUTRITION AND SPECIFIC THERAPY 

fare, good results and a lack of the common ailments and 
diseases of childhood are practically inevitable. 

Goat's Milk. — Goat's milk has been used especially for 
infant feeding from early historic times, particularly in 
Italy, Switzerland, France and Germany. Its use has 
certain advantages over that of cow's milk, and it is con- 
cerning these that J. K. Culvin 1T writes an article that is 
worthy of consideration, and from which the following 
points of interest are taken: — 

Spargo states that the neglect of the goat as a milk animal, 
especially for infants, is much to be deplored. Rosenau says 
that the goat's milk seems to be well fitted for the human 
infant, and that it is a great pity it is not more generally 
employed. Goats are practically immune to tuberculosis. 

The goat is especially useful to those who desire a small 
amount of milk, and do not have room or cannot afford to 
keep a cow, and great benefit is thus derived from having 
fresh milk at hand at a low cost. 

Chemical Composition of Goat's Milk 

Water 86.88 

Protein 3.76 

Fat 4.07 

Carbohydrate 4.64 

Ash 0.85 

From these figures it is clearly seen that the food prin- 
ciples in cow's milk and goat's milk are very similar 
quantitatively. 

Chemically, there is more difference. The casein coagulum 
is a little more firm than that of cow's milk. The fat closely 
resembles that in human milk. Goat's milk fat is richer in 
insoluble acids than cow's milk fat, but on the whole there 
is very little difference. Eegarding the salt content, goat's 
milk differs from cow's milk in containing tricalcium phos- 
phate, di- and tri-magnesium phosphate, monopotassium 

17 Arch. Pediat., Sept., 1921. 



INFANTS' DIETS; CHILDREN'S DIETS 135 

phosphate and no monomagnesium or dipotassium phosphate. 
There are more chlorides in goat's than in human and cow's 
milk, and sodium and potassium chlorides are present in the 
former but not in the latter. 

The goat has been called the "poor man's cow" because 
the expense of keeping a goat is much less, and the goat pro- 
duces much more milk in proportion to its size. They are 
hardy animals, and will supply sufficient milk for the average 
family, and can be kept where it would be impossible to keep 
a cow. A goat can be kept on a small plot of grass, and 
fresh, pure milk can be easily procured. 

Dr. DeSanctis' 18 conclusion regarding the cause of the 
benefit derived from the egg yolk is different from that 
stated by the author as the possible cause throughout the 
chapter. 

This experimental proof of the value of egg yolk in the 
feeding of nursing infants should shed new light on the 
modification of cow's milk in certain difficult cases at least, 
if not in the case of all normal infants. 

One teaspoon of soft boiled egg was added daily to the 
formula. The response was an immediate gain in weight 
in a three months' old infant which had been receiving 
whole milk, water and dextri-maltose. The yolk was 
gradually increased until the whole yolk was added daily. 
Dr. DeSanctis attributes the 8-12 ounces gained weekly 
to the addition of the fat-soluble A vitamine. Since the 
first experiment, he has used the egg yolk in many cases 
with the same results, even in cases in which orange juice 
had been used. 

18 "Egg Yolk in Infant Feeding," Arch. Pediat., Feb., 1922. 

(This article was published after this book was in press.) 



CHAPTER IX 

VITAMINES 

The subject of vitamines is not more than eleven years 
old. Vitamines have existed through countless ages, yet 
man has been entirely ignorant of them, and even at the 
present time, very little is known of their nature. 

However, one very important fact concerning them has 
been learned, and that is that they are absolutely neces- 
sary for a healthy body. For this reason they have been 
appropriately designated as the "sixth food principle." 

A great deal of research work is being devoted to them 
both in Europe and America. In our own country Dr. 
L. B. Mendel of Yale University, Dr. T. B. Osborne of 
the Connecticut Experimental Station, Drs. E. V. Mc- 
Collum and N. Simmonds of The Johns Hopkins Univer- 
sity, Drs. Alfred Hess and L. J. Unger of New York, 
Drs. H. Steenbock, E. B. Hart, P. W. Boutwell, H. E. 
Kent of The University of Wisconsin, — Drs. S. S. Zilva, 
A. Hardin, J. C. Drummond, K. H. Coward, F. G. Hop- 
kins, E. Mellanby, E. M. Hume, H. Chick of England 
and others of Europe and America have proved interest- 
ing facts. 

Vitamines are as yet substances very poorly defined. 
The word was first proposed by Casimir Funk, a Pole. 
They have also been termed "accessory food substances" 
by Hopkins of England, a very misleading designation. 
Much criticism has been expended on the term vitamine. 
The termination "amine" denotes nitrogen is present, 
while the first part of the word signifies the necessity of 

136 



VITAMINES 137 

this substance to life. But, as a matter of fact, the char- 
acter of these substances is a mystery. 

There is a general opinion to-day that certain diseases 
are caused by deficiencies in the diet, and that these defi- 
ciencies are in other words, vitamines. Each "deficiency 
disease" is said to be produced by the absence of a par- 
ticular vitamine. In this sense the vitamines must be 
specific. Xerophthalmia, and beri-beri are said to be the 
result of the absence of certain vitamines in the food, 
although Dr. Hess says that even in beri-beri the degenera- 
tions are not so sharply defined as in scurvy. Scurvy, 
although conclusions concerning this disease are very con- 
flicting, rickets, pellagra, anemia, neurasthenia and other 
diseases are claimed to be the result, in part, of the ab- 
sence of these substances. 

There are three known vitamines, — the fat-soluble A, 
the water-soluble B, and the water-soluble C. The first is 
sometimes called the antirachitic vitamine, the second the 
antineuritic vitamine, and the third the antiscorbutic 
vitamine. 

In general, the foods that are lacking in these vitamines 
are refined cereals, salted and dried meats, canned foods, 
dried foods, foods subjected to* long periods of cooking and 
a few to short periods of cooking. "Storage organs," such 
as cereals and white potatoes, are low in vitamine A. 
Leafy foods, such as lettuce, cabbage and cauliflower, are 
valuable for vitamine A. Alkalies have a tendency to de- 
stroy at least the antiscorbutic vitamine. For this reason 
soda should not be added to the water in which vegetables, 
navy beans, etc., are cooked. Foods which are acid, such 
as oranges and tomatoes, retain their potency when raised 
to high temperatures, or dried. 

It is said that a certain amount of vitamines can take 
care of only a limited amount of carbohydrate. This fact 
in the author's opinion may account for many acute and 
chronic diseases, especially among people who are given 



138 NUTRITION AND SPECIFIC THERAPY 

to eating excessive quantities of cane sugar lacking in min- 
eral matter. 

Prominent among the detailed facts, so far as research 
men have been able to ascertain, certain points of interest, 
concerning the three vitamines, are given as follows : — 

The antirachitic or fat-soluble A vitamine is abundant 
in butter fat, egg yolk, cod-liver oil, and, to a little less 
degree, in beef fat, and the glandular organs of animals. 
It is found in small quantities, in comparison to these 
foods, in the fats and oils of the vegetable kingdom, in 
fruits, cereals, legumes, nuts, lettuce, cabbage, carrots, 
potatoes, etc. It is more abundant in foods in which yel- 
low coloring matter is present. H. Steenbock/ P. W. 
Boutwell and others have found considerable quantities in 
carrots and sweet potatoes, and these may be classed, in re- 
spect to the fat-soluble vitamine, with the leafy foods, 
spinach, celery, lettuce, cabbage, beet greens, etc. Yellow 
maize for the same reason is high in this vitamine, while 
white maize is low. Cereals, white potatoes, parsnips and 
beets have a small proportion in comparison to these foods 
rich in yellow and green coloring matter. This vitamine 
is not very resistant to heat, for it is destroyed by aera- 
tion at 100° C, the length of time varying with the differ- 
ent foods. Drying is not as fatal to it as to water-soluble 
C. Its absence has many times been charged as the cause 
of rickets, or as a contributing cause of this disease, but 
the most recent investigations seem to prove that the lack 
of fat-soluble A is not the only cause. 

Dr. Alfred Hess 2 has made numerous experiments, and 
concludes that sunlight has a dominant influence on the 
etiology of rickets, and that it not only brings about a 
clinical cure of the characteristic lesions, but also brings 
about an increase in the inorganic phosphorus of the blood. 
Drs. Hopkins and Mellanby of England, and Funk have 

1 J. Biol. Chem., Jan., 1920. 
V. A. M. A., Jan., 1922. 



VITAMINES 139 

claimed it was caused by the absence of the fat-soluble A 
vitamine, while Dr. Hess claims that an abundance of 
vitamine A does not prevent rickets. He maintains that 
an all around complete diet is a determining factor in this 
disease. 

Howland and Kramer claim a low content of inorganic 
phosphorus in the blood of a child is nearly conclusive evi- 
dence of rickets. 

Eric Pritchard of England has said rickets may be due 
to an acidosis, in which case the mineral matter may be 
withdrawn from the bones for the purpose of neutraliza- 
tion. Children frequently well fed develop it. 

McCollum, Osborne and Mendel have claimed that this 
vitamine is necessary for growth, and that its absence gives 
rise to xerophthalmia. 

Sidney Walker, 3 however, claims that the lack of fat- 
soluble A produces xerophthalmia in a variable percentage 
of experimental animals, and that there is obviously 
another factor or factors causing this disease not yet 
worked out. 

McCollum and Simmonds 4 have published the follow- 
ing recent conclusions regarding the etiology of rickets : — 

Mellanby has reported the production of rickets in puppies 
by diets deficient in their content of fat-soluble A. Unfortu- 
nately it has not been possible to evaluate Mellanby's results 
by reading his published writings since he has never supplied 
objective proof of the production of rickets in the form of 
illustrations showing the appearance of his specimens through 
the microscope. This omission has been unfortunate in as 
much as the diagnosis of this disease can be made with cer- 
tainty only on the evidence derived from microscopic changes 
in the bones. The gross deformities which characterize 
rickets can be simulated in other pathological conditions. 
Evidence afforded by the X-ray is not convincing. 

9 J. A. M. A., Jan., 1922. 

4 Bull. Johns Hopkins Hosp., May, 1921. 



140 NUTRITION AND SPECIFIC THERAPY 

Through experiments these investigators conclude : — 

Diets which were low in their content of fat-soluble A and 
phosphorus produced, in the majority of the young rats 
placed upon them, pathological conditions of the skeleton hav- 
ing a fundamental resemblance to rickets. The pathological 
conditions produced were not identical, however, with that 
disease as it usually manifests itself in the human being. 

When the deficiency in the phosphorus was compensated 
for by the addition of a complete salt mixture containing the 
phosphorus ion, the deficiency in fat-soluble A still existing, 
no pathological changes of rachitic nature developed. The 
addition of the phosphorus ion to the diets deficient in it 
and in the organic factor, prevented therefore, the develop- 
ment of any changes of a rickets-like nature. 

The phosphorus ion in the diet may be a determining in- 
fluence for or against the development of rickets. 

If the phosphorus content of the diet is sufficiently high, a 
deficiency of fat-soluble A cannot cause rickets-like changes 
in the skeleton. A deficiency in fat-soluble A cannot be the 
sole cause of rickets. Conversely, it is necessary that the diet 
be low in its content of phosphorus, all other factors, except 
fat-soluble A, being optimal for rickets-like conditions to 
develop. 

Since the addition of the phosphorus ion to the diet pre- 
vented the development of the rickets-like changes in the 
skeleton, but had no effect in preventing xerophthalmia, it 
seems permissible to infer that xerophthalmia and rickets do 
not have an identical etiology. 

The above results do not in our opinion exclude the fat- 
soluble A from consideration as an etiological factor in the 
production of rickets and kindred diseases, since the level of 
the blood phosphorus is, in all probability, determined in 
part by the amount of the fat-soluble A available for the 
needs of the organism. 

P. G. Shipley, E. A. Park, E. V. McCollum, N. Sim- 
monds, and H. T. Parsons 5 have found that cod-liver oil 
6 J. Biol Chem., Jan., 1921. 



VITAMINES 141 

causes calcium salts to be deposited in the cartilage and 
bones in rats and that therefore, its administration is bene- 
ficial in rickets. 

E. A. Park and J. Howland 6 claim cod-liver oil is a 
specific for rickets. 

This disease is very common, and is characterized by 
impaired nutrition, extreme sensitiveness, fever and soft 
muscles and bones. 

The antineuritic or water-soluble B vitamine was dis- 
covered about the same time by a different group of in- 
vestigators. Funk proved that butter fat has no power 
to cure polyneuritis in birds or beri-beri in man, and later 
McCollum solved the question, and designated these two* 
substances as A and B. B is abundant in unrefined 
cereals and yeast and present in smaller amounts in 
legumes, eggs, milk, fruits, vegetables, roots, tubers, nuts 
and glandular organs. It is the most abundantly distrib- 
uted in nature and is the most resistant to heat as it resists 
autoclaving for an hour. 

Beri-beri which is caused by the absence of this vita- 
mine, in part, if not entirely, is characterized by numb- 
ness, cramps, catarrh, edema, pain and swelling in the 
limbs, and finally paralysis. 

The third vitamine that has created much interest is 
the antiscorbutic or water-soluble C vitamine. But ac- 
cording to McCollum and his coworkers there is doubt as 
to the relation of this vitamine to scurvy, as they claim 
there is no protective substance against this disease, and 
that it is not a deficiency disease in the same sense of 
xerophthalmia and beri-beri. Other authorities claim the 
lack of this vitamine is the cause of scurvy. Dr. Funk 
was the first to pronounce this fact. Vitamine C is the 
most abundant in fresh fruits, vegetables, roots and tubers, 
especially oranges, lemons, tomatoes, cabbage, potatoes and 
turnips. Milk is low in this vitamine. It is also found 

fl Bull. Johns Hopkins Hosp., Nov., 1921. 



142 NUTRITION AND SPECIFIC THERAPY 

in germinated cereals and legumes, according to Chick 
and Hume. 

'Heat seems to affect water-soluble C vitamine differ- 
ently in different foods. For instance, heat apparently 
destroys it in milk, but not in orange juice, tomatoes, or 
potatoes, that is if they are not subjected to long periods 
of cooking. Generally speaking, this vitamine is the most 
susceptible to heat. 

Some investigators claim aging destroys water-soluble 
C vitamine more than heat. However, it is difficult to 
reconcile this conclusion to the fact that scurvy has been 
known to develop in breast-fed infants. In this case the 
mother's milk may be at fault, and this vitamine present 
in an insufficient amount. Drummond, Coward and 
Watson 7 say it was originally shown by McCollum, Sim- 
monds and Pitz (1916) and confirmed by Drummond 
(1918) that the milk secreted by the lactating female will 
tend to be deficient in vitamines unless her diet contains 
adequate amounts of these substances. More recently a 
great deal of experimental evidence has been obtained in 
support of these observations, and from our own observa- 
tions we are inclined to believe that this cause is by far the 
most important in causing such variations. 

Dr. Hess claims that aging causes the destruction of this 
vitamine through oxidation. This theory has been con- 
firmed by Zilva at the Lister Institute of Medical Research 
in London. The facts at present available point to the 
sensitiveness of both the fat-soluble A and the water-sol- 
uble C vitamine toward oxidative influences, whereas the 
water-soluble B vitamine seems far more stable towards 
heat and oxidation. 

Dr. Hess has had unusual opportunities to observe the 
results of milk modifications in New York, and has made 
a special study of scurvy. He says cases of scurvy have 
developed upon almost every diet given to children, — on 

'Biochem. J., Vol. XV, No. 4, 1921. 



VITAMINES 143 

pasteurized milk, milk rich or poor in fat, buttermilk, 
albumin milk, raw milk and mother's milk. It is prob- 
able that all these milks had lost their antiscorbutic power 
through aging, mother's milk excepted, or that they were 
poor in mineral substances, or lacking in vitamine C. 

His classification of scurvy is as follows : — 

In the latent stage there is stationary weight, pallor, 
and anorexia, edema, exaggerated knee jerks and cardio- 
respiratory syndrome. 

In the sub-acute stage the above symptoms are more 
marked, and there is enlargement of the heart, irritability, 
redness of gums, tenderness of extremities, and perhaps 
blood and albumin in the urine. 

In the florid stage there are hemorrhagic disturbances. 

It is a well-known fact that the first two stages are often 
unrecognized. 

W. Pitz 8 claims lack of calcium may be a contributing 
cause of scurvy. An "incomplete protein," and the char- 
acter of the flora of the digestive tract may also play a part 
in its development. Pitz has suggested that calcium salts 
may control the permeability of various animal tissues and 
thereby afford protection against invading agents. The 
various functions of calcium are again emphasized. 

Shipley, McCollum and Simmonds 9 have found that 
rats fed a diet complete, except for the absence of vita- 
mine B, developed lesions in the bones essentially identical 
with those seen in guinea pigs suffering from acute and 
uncomplicated scurvy. Eats confined to the same diet 
supplemented with B do not show these changes. The 
bones of rats on a diet which is only deficient in A are 
osteoporotic, but have no other resemblance to the bones 
of scorbutic animals. These results appear very puzzling, 
and some future explanation is hoped for from these in- 
vestigators. 

8 J. Biol. Chem., Nov., 1918. 

9 J. Biol. Chem., Dec., 1921. 



144 NUTRITION AND SPECIFIC THERAPY 

Orange juice is heralded as the prototype of antiscor- 
butics, — it invariably helps and generally cures this 
disease. 

Dr. Hess has spent considerable time in trying to find 
a substitute for orange juice as this is expensive for many 
families. He tried yeast and found it did not produce 
good results. Potato water with some of the pulp, and 
tomato juice, however, proved most beneficial. (Allow 
twice the amount of these of orange juice, following the 
schedule in Chapter VIII.) The juices of oranges and 
tomatoes may be given in a nursing bottle when they 
amount to four or six ounces, according to the age of the 
child. Canned tomatoes may be substituted for fresh 
tomatoes, if necessary, and given when orange juice is not 
tolerated or available. 

Pellagra has been said to be another deficiency disease, 
although the exact cause is very doubtful along with 
rickets and possibly scurvy, and beri-beri. It has been 
claimed that the true cause was worked out at the Univer- 
sity of Rome by Professors Alessandrini and Scala whose 
conclusions were that it is a chronic acid intoxication, 
and not an infection, and is caused by drinking soft water 
coming from a clay soil, and prevented by drinking water 
rich in calcium and magnesium carbonates. 

The author does not deny these facts, but if the lack of 
carbonates is the cause, why should not foods lacking in 
these minerals be a cause also, — why should the cause be 
limited to soft drinking water? Poods lacking in these 
minerals, through kind or preparation, would seem to be 
the more probable cause. These investigators claim pel- 
lagra is cured by the hypodermic injection of a 10 per cent 
solution of sodium citrate, in doses of 1 c.c. daily for 15-30 
days, according to the severity of the case, then on alter- 
nate days for as long a time. Why should hypodermic 
injections of an alkali be necessary when many foods are 



VITAMINES 1*5 

rich in these minerals, and would supply them with none 
of the risks of hypodermic injections? 

Pellagra has been known frequently to develop among 
well-to-do classes as well as among the poorer classes. 
From this fact the cause seems to point to an auto-intoxi- 
cation caused by a diet lacking in mineral substances, and 
possibly "complete protein" and vitamines A and B. 
Those interested in the subject know that pellagra can be 
cured by a scientific diet. 

McCollum, Simmonds and Parsons 10 hold the view that 
pellagra may be caused by the lack of mineral substances 
in the diet, especially calcium, and the lack of fat-soluble 
A and a deficient protein. H. C. Sherman, J. C. Winters, 
V. Phillips and E. V. McCollum think an infective agent 
is involved in pellagra, induced by faulty nutrition. This 
conclusion again substantiates the author's conviction con- 
cerning the lack of antibodies, produced in part by an 
inadequate mineral supply, as a contributing etiological 
factor in some so-called deficiency diseases. Where pel- 
lagra is common large amounts of refined wheat, rice and 
corn, and much sugar, molasses and meat, especially pork, 
are used. The diet is lacking, for the most part, in milk, 
eggs, leafy vegetables and fruits. Leafy vegetables, fruits 
and milk are rich in calcium, and vitamine A, and eggs 
have a smaller amount of calcium and a larger amount of 
vitamine A. Leafy vegetables and fruits supplement the 
cereals, legumes, roots and tubers in mineral substances, 
protein and vitamine A, according to McCollum and his 
coworkers. They also supplement meats in mineral sub- 
stances and vitamines. 

Pellagra is characterized by weakness, indigestion, 
nervous affections and eruptions. 

Conclusion. — These many facts concerning vitamines 
should require much consideration in all manipulations to 
10 J. Biol Chem., May, 1919. 



146 NUTRITION AND SPECIFIC THERAPY 

which foods possessing these necessary substances are sub- 
jected, and again special emphasis should be laid on the 
value of fresh, raw fruits and vegetables, and short periods 
of cooking. 

Vitamine D. — Casimir Funk and Harry E. Dubin X1 
have separated from vitamine B a substance which they 
call, provisionally, vitamine D, and which acts on micro- 
organisms. Vitamine D appears to be a definite and spe- 
cific substance stimulating the growth of yeast. 

It may develop that the vitamine D and the vitamine- 
like substance obtained from proteins such as casein, may 
have some special function in the body, and such experi- 
ments are now being planned. 

Dental Caries and Pyorrhea. — Percy R. Howe, 12 assist- 
ant Professor of Dental Research, Harvard University, 
gives the following results of some of his researches which 
appear to be of special interest in connection with the 
study of the effects of the lack of mineral matter and vita- 
mines in the diet, and the possible cause of many infections 
as suggested by the author: 

If the profession of dentistry is to undertake to prevent 
dental diseases it will have to apply other measures than are 
at present employed. We clean the teeth to prevent decay. 
A few hours and the process must be repeated. The cleansing 
must be kept up continuously ... on the other hand, native 
races do not clean their teeth, do not need to and yet do not 
have dental caries. And so it is with the cavities in the 
teeth. They are filled. The fillings are on an average good 
for, say, 5 years. Disintegration of the teeth recurs'. The 
teeth are again filled, and the filling lasts for a few more 
years. Then the process is repeated. We have not in either 
case removed the cause of the caries. 

Our preventive measures are based on the theory of Miller, 
who held that caries is due to the fermentation of carbohy- 
drate with the formation of lactic acid. 

11 J. Biol. Chem., Oct., 1921. 

12 The Dental Cosmos, Nov., 1921. 



VITAMINES 147 

Now, while Miller was able to affect some extracted teeth 
in a test tube by fermenting bread with saliva, he was unable 
to produce any effect upon the teeth of living animals. He 
thinks that it is the structure of the teeth that prevents the 
decay. He continuously speaks of tooth structure as a most 
decided factor in caries. But be this as it may, the fact 
remains that when Miller's theory is applied to living animals, 
it produces no effect upon the teeth. I have elsewhere stated 
that after feeding 30 guinea pigs for a year upon various 
sugars and starches and microorganisms, no effect upon their 
teeth was discernible. The teeth of the guinea pig are very 
easily decalcified in a test tube, decalcification being only a 
matter of an hour or so, while the human tooth requires a 
number of days. It is evident then that the structure of 
the teeth of these animals is very favorable for the fermenta- 
tion process to affect it, yet in the living state acids from 
fermentation have no effect. 

It is now possible entirely to decalcify the teeth of guinea 
pigs by an alteration in their diet which may be compared 
to the difference between natural foods and refined foods. 
... In some instances distinct cavities have formed. Ground 
sections show that the dentin is badly disintegrated. The 
destructive effects are rapid and severe. This seems to be 
very similar to true dental caries. 

Secondly, the alveolar process is absorbed, the teeth become 
very loose and protrude from their sockets, and the articula- 
tion is disarranged. Inflammatory and degenerative changes 
occur in the peridental tissues. Indeed the condition closely 
resembles pyorrhea. Elsewhere we have shown that the in- 
jection of microorganisms into the gums produces no condi- 
tion that simulates pyorrhea. The infection then is not the 
causative factor but is secondary. . . . 

Irregularities of the teeth ojccur — carious areas are found 
in the jaws . . . considerable areas of the jaws become decal- 
cified. Upon a return to normal diet large plaques of new 
bone form. 

It is a common theory to associate tooth difficulties with 
eye troubles. Eunning eyes occur with regularity in scor- 
butic feeding . . . many of our specimens of guinea pigs' 



148 NUTRITION AND SPECIFIC THERAPY 

skulls show decalcified areas of the bone in the orbit, usually 
at the base of the teeth. 

In young mothers, whose diets are deficient in respect to 
vitamines . . . some have cloudy spots upon the coatings of 
the eye. With normal feeding these disappear. One animal 
was born with no eyes. ... In another, opacity of the lens of 
both eyes had gradually occurred. . . . After feeding her large 
quantities of orange juice it entirely cleared up. . . . When 
we consider how common dental caries is, and how many 
youngsters have eyes that need correction we may, in the light 
of these experiments, reason that a faulty nutritional diet- 
lies behind both. 

Joint infection regularly follows deficiency in the anti- 
scorbutic vitamine . . . looseness of the teeth occurs at the 
same time. . . . Both are indicative of the same general dis- 
turbance. 

Zilva 13 states that the pulps of the teeth are one of the 
first things affected in antiscorbutic deficiency, and that the 
teeth are profoundly affected. He believes a great deal of 
latent scurvy exists and that caries may be a result of it. 

In calcium disturbances of this kind, two things are to be 
considered, — first, a sufficient supply of calcium, second, the 
necessary elements for inducing the fixation of the calcium. 
The fixation seems to be governed by the vitamine content of 
the food. 

Dr. Howe's researches and conclusions are extremely in- 
teresting not only in relation to the diseases of the jaws 
and teeth, but also in relation to the influence of calcium 
and vitamines in many diseases of the body. 

The author has been convinced of the supplementary 
relationship of mineral matter and vitamines in the sev- 
eral years of lecture work, and the lack of this in a high 
protein diet. Elsewhere in this little volume this has been 
said to be the cause of many organic diseases, and suggested 
as the possible cause of some infectious diseases. 

In this chapter these research men seem to prove that 

13 Proceedings of Royal Society of London Series B., Vol. 90, 1919. 



VITAMINES 149 

lack of vitamines and mineral substances are primarily 
responsible for deficiency diseases, and are the primary 
cause of some infections, the bacteria themselves being the 
secondary cause. 

Pyorrhea is a disease which has probably received more 
attention than any other branch of dentistry, and its prob- 
lem is only partly solved. 



CHAPTEE X 

A FEW HEALTHFUL EECIPES; SOME INVALID RECIPES 
MISCELLANEOUS SUBJECTS 

Chestnut Puree (for those desiring cream). — Boil one 
pound of chestnuts a few minutes, drain and remove skins. 
Boil again until tender. Drain and press them through a 
nut-butter grinder. Sweeten, flavor with vanilla and 
moisten with a little cream. Put the puree in a sauce- 
pan and stir over a slow heat until dry. Then press the 
puree through a colander or potato press onto the dish in 
which it is to be served. Form it into a circle, taking 
care not to destroy its lightness and form. Serve with 
whipped cream in the center of the ring. 

Chestnuts are the best balanced of the nuts. Their 
chemical composition is as follows: — 

Chestnuts Other Nuts 
Protein 6.6 per cent. 15.-25. 



Pat 8.0 

Carbohydrate 45.0 

Mineral Matter 1.7 

Cellulose 7 

Water 38.0 



50.-70. 

10.00 
2.00 
1.-5. 
4.-5. 



A much greater amount of carbohydrate is required for 
health than protein and fat, and the above figures clearly 
demonstrate the excellent proportion of food principles in 
chestnuts. 

The peasantry of France and Italy often eat two meals 
a day of chestnuts. 

150 



MISCELLANEOUS SUBJECTS 151 

Baked Lentils (Meat Substitute) 

2 cups lentils V2 cup bread crumbs 

^4 cup onions 2 cups tomatoes 
^4 cup butter V2 cup cream (if preferred) 

V/2 tablespoon salt Pinch of soda 

1 tablespoonful celery salt 

Wash the lentils and soak in cold water several hours. 
(Do not drain.) Add the onions and boil one hour or un- 
til tender. Add salt and celery salt when they are half 
done. Press tomatoes through a fine sieve, add the soda 
and cream, and heat to the boiling point. Add this to the 
lentils which should be boiled sufficiently dry so that drain- 
ing is not necessary. Place them in a buttered baking 
dish, cover with buttered bread crumbs, and bake in the 
oven until the crumbs are a golden brown. 

Lentils are not as popular as peas and beans, yet they 
are an even more valuable food. They are richer in pro- 
tein and have a much higher mineral content. The largest 
supply comes from Egypt. 

Lentil Toast. — This is made from lentils prepared as 
in the above recipe before they are baked, adding sufficient 
cream and tomato juice to allow them to be poured onto 
buttered toast. This makes a pleasant variation from 
milk toast or egg on toast for invalids. 

Soy Bean Croquettes (cream may be omitted). — Soak 
y 2 pound soy beans over night. In the morning do not 
drain; boil them several hours, until moderately tender. 
(They will not be as tender as navy beans unless cooked 
under pressure. ) Add salt when half done. There should 
be Y2 cup of liquid when the boiling is completed. 

To this % cup bean stock, add % cup cream and two 
level tablespoons cornstarch, and stir until dissolved. Put 
this on to boil and add thyme and bay leaf to flavor. To 
iy 2 cups tomato juice, add a pinch of soda and heat. Add 
the tomato juice gradually to the bean stock and cream 
and season with salt and pepper to taste. 



152 NUTRITION AND SPECIFIC THERAPY 

Pass the drained boiled beans through a meat grinder, 
and add to them two small onions cut fine, one egg yolk, 
and salt and pepper to taste. To this mixture, add the 
cooked oatmeal which is used as a binding agent (^4 the 
quantity of the soy beans). (Recipe for oatmeal toast 
used.) 

Mix thoroughly, and form into croquettes. Heat them 
in the sauce already prepared, and serve garnished with 
water cress. 

Oatmeal Toast. — To iy 2 cups boiling, salted water, add 
1 cup oatmeal, stirring constantly until thick and stiff, 
which will require but a few minutes' boiling. (This is 
used as a binding agent in the above recipe.) 

To serve as oatmeal toast, turn it into a bread pan. 
When cold, cut in thin slices, and fry in Crisco or Snow- 
drift. 

Soy Bean Cookery. — For those who are interested in 
soy bean cookery and its beneficial results, there are many 
recipes for gruels, muffins, breads and cakes. However, 
almost any recipe for these can be used substituting one- 
half of the wheat flour called for with soy bean flour. 

The bean is so rich in fat that in China and Japan a 
variety of cheese is made from it. In England a new 
vegetable milk has been produced from it in the following 
manner: — The beans are soaked for a few hours, and 
finely ground in a meat grinder. They are then boiled 
in about three times their volume of water for a half hour. 
The liquid is then drained, and it has an appearance of a 
milky emulsion very similar to cow's milk. This vege- 
table milk can be used in breads, cakes, custards, etc. It 
has a slightly acid reaction, it curdles through the action 
of rennet, and upon standing, it develops lactic acid. This 
is often of great value in certain cases of diarrhea and 
malnutrition. 

A product similar to peanut-butter can be made from 
the soy bean. This is especially recommended by the 



MISCELLANEOUS SUBJECTS 153 

author as an excellent food for children for spreading on 
bread and toast. It is easily prepared by passing the dry 
beans through a meat grinder, and then through the nut- 
butter grinder. (The latter is difficult to use the first 
time.) Place the ground beans in a shallow pan in the 
oven and parch, stirring frequently. Mix with them salt 
and enough olive oil or other vegetable oil to make a paste. 

Chemical Composition of the Soy Bean (Average) 

Water 10.00 per cent. 

Protein 37.13 " " 

Fat 18.38 " " 

Carbohydrate 24.40 " " 

Lecithin 1.60 " " 

Mineral Matter 4.30 " " 

Cellulose 4.47 " " 

Almond Milk. — This is another vegetable milk that is 
creating considerable interest. It is recommended for 
adults in cases of typhoid fever, intestinal putrefaction, 
nephritis, anemia, malnutrition, fermentation, for infants 
with whom cow's milk or mother's milk does not agree, 
and in cases of rickets. It ferments much less readily 
than cow's milk, and its protein is less subject to putrefac- 
tion in the intestines. It has a higher fat content than 
cow's milk and a lower sugar content, and contains a 
large amount of phosphorus, and a smaller amount of 
sodium chloride. 

To prepare the milk, the nuts are finely ground, covered 
with water, and allowed to stand in the refrigerator over 
night. They are then pressed through a potato ricer and 
strained through gauze. One hundred grams of nuts may 
be covered with 200 grams of water, and when strained 
this is diluted up to 300 c.c. water. This milk must be 
kept cold to prevent fermentation. 

The chemical composition of this milk compared with 
that of cow's milk is as follows : — 



154 NUTRITION AND SPECIFIC THERAPY 

Almond Milk Cow's Milk 

Protein 4.4 per cent. 3.0 per cent. 

Fat 7.0 " " 4.0 " " 

Carbohydrate 1.2 " " 5.0 " " 

Mineral Matter ... .55 " " .7 " " 

Water 86.0 " " 87.0 " " 

Nut, Date and Bran Muffins (for Diabetes) 

3 cups bran % teaspoons soda 

4 eggs % * salt 

3 teaspoons butter % cup English walnuts 

iy 2 cups sour cream or but- % cup dates 
termilk 

Cream the butter, and add the beaten yolks. Add the 
creani, soda, salt, walnuts, dates and bran. Lastly add the 
beaten whites. Bake in a moderate oven 30 minutes if 
muffins are large. 

Nest Eggs. — This may be called a complete food, and 
no other kind need necessarily be served with it as the egg 
furnishes the protein, fat, vitamines, and a liberal amount 
of mineral matter, while the potato supplies a generous 
amount of mineral matter, carbohydrate and vitamines, 
and also a small amount of a so-called "complete protein." 

Wash and bake one large potato. Cut in half, scoop out 
the inside and mash. To % cup mashed potato, add % 
tablespoon butter, 1 tablespoon cream and a pinch of salt. 
Line the potato shell with this mixture, place the yolk 
or whole egg, if the potato shell is large enough, in the 
cavity, sprinkle with salt and buttered crumbs, and bake 
until the potato mixture is slightly browned. 

Rice may be used in the same way, as natural brown 
rice is a substitute for potato in many respects, if the 
potato is eaten with the skin. 

Rice versus the Potato. — Every one probably has heard 
much about rice as a potato substitute. Standard head 
rice such as is generally purchased is not a substitute for 



MISCELLANEOUS SUBJECTS 155 

the potato. This rice, lacking in salts, protein and vita- 
mines must not be confounded with the potato which is 
rich in salts and vitamines, especially if it is eaten with 
the skin, according to McCollum, 1 and which has an almost 
"complete protein." Hindhede of Copenhagen and others 
have published valuable information on potato protein. 
Natural brown rice, however, is a good substitute for the 
potato, although it cannot claim all the qualities possessed 
by its rival. (See Scurvy, Chapter IX; Protein, Chap- 
ter I.) 

The potato contains six times as much calcium, twenty 
times as much phosphorus and five times as much iron as 
standard head rice. It costs considerable money to mill 
this refined rice, while it costs only about one-sixth as 
much to mill natural brown rice. The average consumer 
prefers the snow-white appearance of the denatured, re- 
fined product to the health-producing substances of the 
natural product, which includes mineral substances, vita- 
mines A and B, and a small amount of protein. 

The commercially known "Unpolished Rice" is very 
misleading. One would be led to believe that the outer 
bran had not been removed. However, it has partly been 
removed, and the rice is then treated with glucose and 
talcum, although not to the extent that these substances 
are applied to the ordinary commercial rice. Natural 
brown rice can be purchased at certain pure food stores. 

While the potato is an excellent food, it is not an ideal 
food, as it is too low in calcium, sodium and chlorine and 
vitamine A for the promotion of nutrition at the optimum 
rate. McCollum compares the properties of the potato to 
the cereals, and says it remains for future investigators 
to show whether or not the coagulated protein of "the 
potato has a higher biological value than those of the 
cereals. Like the seeds, "it consists largely of reserve 
food materials and relatively little of cellular elements." 

1 "The Newer Knowledge of Nutrition." 



156 NUTRITION AND SPECIFIC THERAPY 

Therefore, its mineral and vitamine content should be 
supplemented by leafy foods. 

Souffled Eggs. — Beat the white of an egg until stiff and 
season with a pinch of salt. Butter a tumbler or cup, pour 
the white into it, and place the cup in a pan of warm 
water, allowing the water to heat gradually until the boil- 
ing point is reached. As the white rises, make a depres- 
sion and drop in the yolk, allowing it to remain until thor- 
oughly hot. 

Steamed Eggs. — Butter small molds, and sprinkle with 
finely chopped parsley. Carefully slip an egg into the 
mold, and sprinkle with salt. Place the mold in a pan of 
boiling water to % its depth, and allow the egg to cook 
until the white is film, keeping the water below the boil- 
ing-point. Remove from the mold, and serve with tomato 
sauce. 

Egg Timbales. — Beat 1 egg slightly, add 1 tablespoon 
of cream, a few drops of onion juice if desired, and a pinch 
of salt and celery salt. Turn the mixture into a small 
buttered mold. Set it in a pan of hot water, until firm. 
Remove the mixture from the mold, and serve with cream 
or tomato sauce 

Oatmeal Cookies. — These are especially recommended 
for children in place of sweets. The ingredients, before 
baked, will be found difficult to bind together, — a little 
pressure, however, after they are dropped onto the baking 
sheet will overcome this difficulty. 

1Y2 cups rolled oats 1 tablespoon vanilla 

y 2 cup sugar (brown) 1 " melted butter 

2 eggs Y2 teaspoon salt 

Mix ingredients thoroughly, drop from a spoon onto a 
baking sheet, and bake about five minutes or until a golden 
brown. 

Gruels for Infants and Invalids. — Gruels can be made 
either from the grain or from the flour of any cereal or 



MISCELLANEOUS SUBJECTS 157 

legume. If the flour is used, it should first be mixed with 
a little cold water, then added to the boiling water. If 
made with milk, they should be cooked in a double boiler. 
For young infants they should be strained through a fine 
puree sieve before being served. 

Mix 1 tablespoon unrefined cereal flour with a little 
cold water, and add, gradually, to a pint of boiling water 
(or milk, if preferred). Add 2 level teaspoons milk or 
malt sugar, a pinch of salt, and boil the mixture for ten 
minutes very gently. If too much water boils away, add 
sufficient water to make a cup of gruel when it is served. 
Legume and cereal gruels may be served very thick if 
desired by doubling or tripling the amount of cereal flour 
or legumes. (Recommended in certain difficult cases.) 2 

Legume Purees. — Legume purees for children and in- 
valids are made by boiling the legumes in salted water 
until tender, then rubbing them through a puree sieve. A 
binding agent is sometimes desirable, and this is furnished 
through mixing a small amount of wheat flour with a little 
cold water, or with butter and adding it to the puree. 
These also can be served thick or thin, and different herbs 
added for flavoring, or a few drops of onion juice or to- 
mato juice. (The odor and flavor of the onion is due to 
allyl sulphide which is claimed to stimulate the flow of 
gastric juice, and to act as a mild laxative.) 

Albumin Water for Infants and Invalids. — Beat the 
white of an egg until light, and strain through muslin. 
Add four ounces of water and a pinch of salt. A teaspoon 
of malt or milk sugar may be added in fever cases, and 
also a small amount of orange or lemon juice. 

Drinks for Children and Invalids. — These are especially 
recommended in fevers : — 

Jelly and Ice. — With an ice scraper, chip y 2 cup ice 
very fine. Mix with it the same quantity of any kind of 
jelly. 

i a H. R. Mixsell, Arch. Pediat., Aug., 1920. 



158 NUTRITION AND SPECIFIC THERAPY 

Grape or Current Water 

6 tablespoons jelly y 2 cup cold water 

% cup boiling water Lemon juice 

Dissolve the jelly in the boiling water, add the cold 
water and lemon juice. Serve ice cold. 

Apple Water 

1 apple Lemon juice 

1 cup boiling water Sugar 

Cut the apple with the skins into small pieces. Add 
the boiling water, sugar and lemon juice to taste, strain 
and serve ice cold. 

Egg Lemonade 

1 egg 3 tablespoons lemon juice 

2 tablespoons sugar 1 cup cold water 

Beat the egg, and add the sugar, lemon juice and water. 
Serve ice cold. 

Strawberry Whip 

1 cup fresh strawberries 

Whites of 2 eggs 

*4 cup powdered sugar 

Mash the berries, beat the whites until stiff and add the 
berries and sugar. 

Albuminized Orange or Grape Juice 

White of 1 egg beaten stiff 
Juice of 1 orange or grape juice 
Sugar to taste 

Serve ice cold. 



MISCELLANEOUS SUBJECTS 159 

Grape Juice and Egg 

1 egg 

1 tablespoon sugar 

3 tablespoons grape juice 

Beat yolk and white separately. Add the grape juice 
and sugar to the yolk and fold in the beaten white. Serve 
ice cold. 

Coconut. — The coconut has a lower percentage of pro- 
tein and fat and a higher percentage of carbohydrate than 
the other nuts (chestnuts excepted). For this reason it is 
a better balanced food, and an excellent food when thor- 
oughly masticated. A great deal of the so-called indiges- 
tion resulting from nuts is produced because they are not 
properly masticated, and because they are eaten in con- 
junction with many other foods. They should be the main 
dish at whatever meal they are served. 

Carl O. Johns, A. F. Finks and Mabel S. Paul 3 have 
shown that the globulin of the coconut produces normal 
growth in rats when used as the sole source of protein in 
an otherwise complete diet. Commercial coconut press 
cake furnishes the necessary protein for growth at almost 
a normal rate. 

Coconut press cake contains sufficient water-soluble 
vitamine and experiments indicate that it also contains 
some fat-soluble vitamine. 

Yeast Cure. — If quantities of popular advertising and 
a common topic of conversation possess any virtue at all, 
the "yeast cure/' both for internal and external use, must 
be awarded the highest reputation. The majority of people 
admit a certain degree of ill health of some nature and all 
are grasping for the much-heralded panacea. They seem 
to feel if they can take a kind of medicine which at the 
same time is considered a food, miracles will result. But 
3 J. Biol. Chem., April, 1919. 



160 NUTRITION AND SPECIFIC THERAPY 



if certain healthful foods are suggested to these people as 
a cure, lacking in the medicine attribute, generally they 
have not the slightest interest unless these foods are those 
for which they have a particular liking. 

The chemical composition of yeast 4 is given by Zellner 
as follows : 

Per cent. 

"Insoluble Albumin 12 

Nucleins and Peptones 45.2 

Albumoses 1.6 

^Ammonia Compounds 1.48 



Nitrogenous 
Substances 
48.4 per cent, 



Ternary 
Substances 
11.8 per cent. 



Mineral 
Substances 
13.8 per cent. 



Fatty Bodies 

Olein 

Glucose 

Invertine 

Glycogen 

Cbolesterin 

Succinic Acid 

Phosphoric Acid 51.1 

Potassium 38.6 

Magnesium 4.1 

Calcium 1.9 

Sulphates of Soda and Silica 4.0 



The high protein content of yeast resembles casein, and 
much of the nitrogen is non-protein represented by such 
substances as nucleic acid and its derivatives. Yeast is 
very rich in mineral matter. There is one other substance 
which it contains, in large quantities, — the water-soluble 
B vitamine. 

It is admitted v that certain cures have been wrought 
through the feeding of yeast. It has been known to cure 
disease among encamped armies. But its use for human 
consumption has been suggested only recently, for the most 
part, since the great war. During the war in Germany, 
owing to the scarcity of meat, 50-75 grams were commonly 
consumed daily. 

*Zeits. f. Hygiene, XLIL, p. 3. 



MISCELLANEOUS SUBJECTS 161 

But yeast contains certain substances that speak against 
it. These are the purines, and in these its content is very 
high. For this reason yeast produces much uric acid in 
the body. 

Yeast should never be allowed in gastric dilatation asso- 
ciated with motor insufficiency as in these cases it remains 
in the stomach too long. At times yeast produces diar- 
rhea, vomiting and intestinal irritation. 

Cow's milk is low in vitamine B, the amount present 
being dependent upon the vitamine content of the food 
of the cow. For this reason yeast has been recommended 
for infant feeding in connection with cow's milk. These 
experiments proved that yeast produces diarrhea, followed 
by losses in weight, and that it should not be used as a 
means of increasing the antineuritic content of infants' 
foods for the cure of boils or to influence the rate of 
growth. 5 

Diarrhea is only an exaggerated effect of one of its 
much prized virtues, for it is claimed that yeast produces 
lactic and succinic acids in the colon, and that therefore it 
antagonizes putrefactive bacteria. As was clearly ex- 
plained in the chapter on reforming the intestinal flora, 
lactic acid stimulates peristalsis and prevents putrefac- 
tion. If peristalsis is exaggerated, naturally diarrhea 
results. 

For this reason yeast has been much advocated in dis- 
eases of auto-intoxication. 

There are two kinds of yeast, brewer's yeast and grape 
yeast, — both are used, but the best results seem to follow 
from the use of the grape yeast, and in this connection this 
yeast is often obtained by taking the so-called "grape cure," 
when four or five pounds of grapes are eaten daily. 

Jacquemin claims that the failure of brewer's yeast is 
due to the fact that it is not always pure, and that the 
yeast is not always collected at the time of its greatest 

5 A. L. Daniels, Am. J. Dis. Child., Jan., 1922. 



162 NUTRITION AND SPECIFIC THERAPY 

activity. Brewer's yeast is a ferment which develops in 
an almost neutral culture medium, and at a generally low 
temperature. On reaching the stomach it encounters an 
acid medium, a high temperature and unfavorable sur- 
roundings. So it is prevented from producing any bene- 
ficial effect. He therefore advocates the grape yeast which 
is accustomed to high temperatures. 

The conclusion concerning the yeast cures is that the 
effect is only transient. This is the natural supposition, 
unless the cure were continued indefinitely through life. 

In other words, health is dependent upon a certain 
amount of protein, mineral matter and vitamines daily 
(fat, carbohydrate and cellulose not entering into this 
particular discussion) and the production of lactic acid in 
the intestines. There are innumerable foods that contain 
the above three food elements, and that produce lactic acid 
for the prevention of putrefaction, — raw fruits, vegetables, 
cereals, legumes, roots and tubers. There is every rea- 
son in favor of eating these valuable foods daily, and of 
not consuming quantities of yeast in a great effort to ob- 
tain something vital that can be procured in wholesome 
foods of many kinds. There is no question of securing 
favorable results from these foods, — it is a guaranteed 
fact and never a problematic one as in the case of brewer's 
or grape yeast. 

Physiological Action of Olive Oil (E. J. Asnis) : — 

1. Olive oil inhibits the flow of hydrochloric acid. 

2. It exercises a protective action from irritating foods 
in inflamed and ulcerated areas. 

3. It is an antispasmodic affecting the musculature of 
the pylorus, thus causing relaxation of the pylorus. 

4. It hastens passage of foods other than protein from 
the stomach. 

5. It is resistant to the action of fermentation in the 
stomach. 



MISCELLANEOUS SUBJECTS 163 

6. It combats constipation on a normal diet. 

7. It overcomes dysentery and diarrhea on a liquid 
diet. 

8. It increases the flow of watery bile, and therefore 
aids in the passage of gall-stones. 

9. One tablespoon is equal to a glass of milk in calories. 
Cohnheim's conclusions are as follows (Friedenwald, 

Ruhr ah) : — 

1. Cases of dilatation of the stomach due to spasm, 
caused by an ulcer or fissure at the pylorus are cured, or 
markedly relieved by the use of large quantities of oil 
(100-150 grams). 

2. Cases of stenosis of the pylorus due to organic disease 
with secondary dilatation are also usually relatively cured 
by the use of large quantities of oil ; that is, in these cases 
the oil acts mechanically by relieving friction. 

3. Cases of relative stenosis of the pylorus and duo- 
denum which are clinically marked by a continuous hyper- 
secretion and pylorospasm several hours after meals, are 
much improved or cured by the oil treatment. 

4. The pylorospasm found in cases of carcinoma of the 
pylorus is much diminished or relieved by the oil treat- 
ment. 

5. Cases of ulcer of the pylorus associated with or 
without hyperchlorhydria are quickly cured by means of 
the oil treatment, or by an emulsion of sweet almonds. 
(See Almond Milk, page 153.) 

6. The oil is best taken three times daily, half to one 
hour before meals; as a rule it is best to administer a 
wineglassful early in the morning and two dessertspoon- 
fuls before dinner and supper. In mild cases an emulsion 
of sweet almonds may be substituted for it. 

7. The oil fulfills three indications: it overcomes py- 
lorospasm; it relieves friction and tends to improve the 
general nutrition. 



164 NUTRITION AND SPECIFIC THERAPY 

8. The oil acts as a narcotic in cases of pylorospasm, 
producing, however, no unfavorable effects — neither eruc- 
tation nor diarrhea. 

9. In that form of gastric neurosis, manifested by pain 
when the stomach is empty, very favorable symptomatic 
relief has been obtained from the use of olive oil. 

10. A certain number of cases of stenosis of the pylorus 
accompanied by a consequent gastrectasia can often be so 
much relieved by the oil treatment that no operative pro- 
cedure need be undertaken. A trial should be made of the 
oil treatment in all cases of stenosis of the pylorus before 
advising operative procedure. 

11. The treatment prevents prophylactically the pro- 
duction of gastrectasia and prevents relapses when util- 
ized in favorable cases. 

Rutherford's conclusions are as follows: — Upon the 
internal administration of olive oil, typical cases of chronic 
dysentery, practically without exception, show changes 
in their condition as follows: — 

1. Positive evidence of increased quantities of bile in 
the feces. 

2. Decrease in the number of daily bowel movements, 
and marked improvement in the character of the same. 

3. Gradual cessation of signs of fermentation and putre- 
faction along the intestinal tract, and consequent subsi- 
dence of pain and tenderness. 

4. General systemic improvement; gain in appetite; 
repair of digestive faculties; symptoms of improved ner- 
vous system ; rapid gain in strength and weight. 

5. Apparent positive cure after an average time of two 
months and upward, with few recurrences. 

The treatment is started by giving an ounce of olive oil 
three times a day for three days, when the quantity is 
doubled. Rutherford advocates a milk diet and egg albu- 
min with this treatment. Later oil is given in doses of 
3 ounces three times a day. This treatment may neces- 



MISCELLANEOUS SUBJECTS 165 

sarily be kept up for two months. Gradually the patient 
is restored to a normal diet. 

The author would not advise the milk in this diet, but 
in its place would give cereal gruels, thin legume purees, 
vegetable purees, soft eggs and fruit juices. 

The Value of Salt in Food. — For many hundred years 
man has added salt to his diet. It was first used as an 
aliment at the time of transition from the nomadic to the 
agricultural life. The use of salt seems to have been un- 
known to the North American Indians at the time of the 
discovery of America. There are still many tribes of peo- 
ple living remote from civilization that have never tasted 
salt. But among civilized people salt is used to-day in 
excessive amounts. 

It was repeatedly stated in Chapter II that sodium and 
chlorine are essential to the body, and it has been proven 
in recent years by the researches of Morse, Achard and 
many others that foods in their natural state contain a 
sufficient amount of salt for the requirements of the body 
without the addition of commercial sodium chloride. This 
addition seems to be craved by civilized man, and the more 
civilized he is, and the more artificial and complex his 
life, the greater is the quantity of sodium chloride that he 
desires in his food. 

It is an established fact that a certain amount of sodium 
chloride is necessary. With an insufficient amount of 
chlorides, the elimination of chlorine decreases constantly 
in the urine, and finally may stop entirely, while the tis- 
sues at the same time retain their chlorides. Chlorine 
starvation has a marked influence on certain functions and 
the digestive juices, especially the gastric juice. 

Bunge has said the craving for the addition of salt to a 
vegetarian diet is natural as many of this class of foods, 
noteworthy among these the -potato, are rich in potash. 
But other investigators make contrary claims. Richet has 
demonstrated that the foods required per day on a vege- 



166 NUTRITION AND SPECIFIC THERAPY 

tarian diet contain naturally half a dram of salt, and that 
this amount is what is required daily by the body, and that 
therefore no addition is needed. 

One result of an excess of salt is the greater activity of 
the kidneys, for the greater the quantity of commercial 
salt ingested, the greater the quantity of water demanded 
by the body to maintain the normal specific gravity of the 
blood. 

As a natural consequence of the addition of sodium 
chloride to the diet, the blood pressure is raised, but this 
is relieved through water-drinking, by sweating and 
through the kidneys. 

The excessive use of salt in the diet has been claimed 
by some investigators to produce eczema, dyspepsia and 
Bright's Disease. The elimination of added salt to the 
diet is of great value in the treatment of dropsy. The 
following amounts of sodium chloride per pound in cer- 
tain foods are given by Strauss : — 

Uncooked Grains 

Fruits 4.2 

Vegetables 7.0 

Cereals 7-7.0 

White of Egg 13.3 

Yolk of Egg 1.04 

Meat 7.0 

Milk 12.6 

Goiter as Influenced by Iodin. — Dr. E. B. Hayhurst 6 
has published an article worthy of serious consideration 
concerning the question of the significance of iodin in the 
prevention of goiter. The main facts are outlined as 
follows : — 

The subject has been investigated by Marine. Kimball. 
Lenhart, Gaylord, Marsh and others. "Sloan, following 
Marine's suggestion for animals, advocates an iodized salt 

6 J. A. M. A., Jan., 1922. 



MISCELLANEOUS SUBJECTS 167 

for the use of human beings, the proportion of the sodium 
iodid to salt to be 1-5000, and he observes that, in the 
evaporation of salt brines, the mother liquor which is re- 
moved, takes with it the natural content of iodin which is 
originally 'found in most of the salt brines from which salt 
is crystallized/ Both Forbes and Beegle, and Bohn report 
the entire absence of iodin in various forms of market salt 
examined." 

Of the four halogens, iodin is by far the rarest in natural 
distribution, but it always occurs in sea water (Abel and 
Halla). (Chlorin, bromin, iodin and fluorin represent the 
four halogens.) 

The chief natural iodin salt is sodium iodid, and it is about 
five times as soluble as sodium chlorid. This difference in 
solubility undoubtedly explains why there is plenty of the 
former in the earth's deposits, and very little of the latter. 
In the drying up of seas in ages past, sodium chlorid was 
the first substance deposited, and often the supernatant liquid 
escaped with its sodium iodid still in solution. In the second 
place, such sodium iodid as may have been deposited has 
been very largely dissolved out for ages through the agency 
of percolating rains and subsoil waters. Finally, pent up 
sea brines or supernatant salt solutions of both surface and 
subterranean types have been subjected so long to similar 
land-water perfusions as to lose practically all of their more 
soluble constituents. Thus higher surface altitudes are 
freest from iodin, while mineral springs, which represent 
drainings from higher altitudes, show it as among the last 
places of its occurrence. 

This is the explanation given for the absence of iodids and 
other soluble salts in the great natural salt deposits of the 
Alps and elsewhere throughout the world. 

The relative inf requency of goiter along the sea coasts, and 
its mild type when present, is mentioned in most text books. 

All the salt plants of the United States are inland with 
the exception of those along the California coast where 
sea water is the source of supply, but in its manufacture, 
even this is freed from iodin. The finished product aver- 



168 NUTRITION AND SPECIFIC THERAPY 

ages 96 per cent sodium chloride, 3 per cent moisture 
and the balance principally magnesium chloride. 

This brings us to but one logical conclusion. If land ani- 
mals, including man, must have iodin as a necessary content 
of their food intake, its one, natural, reliable source is sea 
water which, however, must be handled and provided in a 
manner to retain the iodin, and this probably in its organic 
form. This raises the important question, — should not total 
sea salts be used as the proper and complete condiment for 
man and land animals ? It must be remembered that it con- 
tains, not only the two discussed essentials, sodium chlorid 
and sodium iodid, but also many other physiologically im- 
portant salts and salines. It is not poisonous. It can be 
filtered free of foreign matter, even bacteria. Plants and 
animals, both sea and land forms, show a selective action for 
such elements as they need for their functions. 

While it is true that most of the sea water elements are 
widely distributed in the balance of nature, and found in 
our usual foods, the great solubility of the combinations in 
which they exist in sea water would appear to warrant giving 
them, in toto, serious consideration in the dietary of man and 
domestic animals. May not also the absence of some of the 
rarer elements, bromin for example, from our usual food 
intake play an important part in the occurrence of various 
excitomotor conditions. 

The author has known the drinking of sea water before 
breakfast to benefit cases of constipation and neurasthenia. 

Uncontaminated sea water has been recommended for 
bread making in France, both on account of its various 
salts required for health, and its magnesium chloride 
which has an affinity for water, and so causes the bread 
to keep moist longer ; but the yeast must be prepared with 
fresh water. 

Canned Foods. — Canned foods should be used only when 
fresh foods are not obtainable. Generally some kind of 
fresh fruit and vegetables are in the market throughout 



MISCELLANEOUS SUBJECTS 169 

the year. However, necessities of various kinds demand 
that either home canned or commercially canned foods be 
used. When this is the case, the fact should be borne in 
mind that the temperature and time of processing, and also 
the period of storage have affected the vitamines. The 
duration of the heating process destroys more vitamines 
than the degree of temperature. Some commercially 
canned foods, peas for example, are subjected to a treat- 
ment called blanching which is destined to remove any 
mucous substance and a part of the green coloring matter 
that a clear liquor may be in the can. This blanching 
water is thrown away. As a result, 2.3 per cent protein 
of peas is thrown away, while the mineral content of 
blanched peas is found to be 46 per cent less than that of 
fresh peas. 

When canned peas, beans, asparagus and sometimes 
corn are prepared for use, they are many times drained 
from the liquor in the can, and as a result there is an 
added loss of soluble protein, carbohydrate, vitamines and 
mineral salts. The natural conclusion is that canned 
foods should not be drained, despite the directions that 
may be given in cook books. 

The bacteriological problem also enters into the ques- 
tion of canned foods, especially in connection with the 
Bacillus botulinus which has proved fatal through its 
toxin in many cases. This bacillus is found both in canned 
meats and vegetables, such as string beans, spinach, aspar- 
agus and ripe olives. 

Boiling destroys the toxin, but not the spores of the 
Bacillus botulinus unless kept at this temperature for 
several hours. 

Harvey Weiss 7 says the thermal death point of spores 
varies with the hydrogen ion concentration of the particu- 
lar food in question, canned fruits requiring shorter pe- 

■/. Infect. Dis., Oct., 1921. 



170 NUTRITION AND SPECIFIC THERAPY 

riods of boiling than vegetables ; it also depends upon the 
concentration of the food, the more fhiid products requir- 
ing a shorter period of boiling; it is influenced by the 
presence and concentration of the syrup, the heavier the 
syrup, the longer the boiling period required. 

Paul F. Orr 8 emphasizes the importance of early diag- 
nosis in botulism as in tetanus and diphtheria because of 
the fact that the benefits of the antitoxin depend upon 
early administration : — 

There are at least two distinct types of botulinus toxin 
known as A and B. The antitoxin is prepared against 
each type and is specific. These facts clearly indicate the 
importance of using both types of antitoxin, provided the 
specific type for the toxin is not known. 

The method of type determination consists in the intra- 
peritoneal injection in each of a number of white mice of 
about .05 c.c. of the filtrate of the infected food. Some of 
the mice have been previously injected with type A anti- 
toxin, and some with type B antitoxin. If previously im- 
munized mice are not available, it is good to mix some of 
the suspected toxin with type A antitoxin, and some with 
type B antitoxin, and then inject the mixture into the mice 
intraperitoneally. Mice of 15-20 gm. weight tolerate 
1 c.c. of non-irritating fluid in the peritoneal cavity very 
well. If the food contains the toxin of type A, the mice 
receiving no antitoxin and those receiving type B anti- 
toxin will die, while those receiving type A antitoxin will 
survive. On the other hand, if the food contains toxin of 
type B, only those receiving type B antitoxin will live. 
In this way both the presence and the type of the toxin 
may be determined in from 4-6 hours. 

R. Graham and H. R, Schwartz 9 have published some 
interesting researches on this bacillus. 

8 J. Infect. Dis., Sept., 1921. 

9 J. Bacterid., Jan., 1921; J. Infect. Dis., April, 1921; J. A. M. A., 
June, 1921. 



MISCELLANEOUS SUBJECTS 171 

The fact should be emphasized that these canned foods 
may contain this bacillus without any visible signs of de- 
composition, but the cases of botulism are comparatively 
rare. 

The possibility of ptomaine poisons must not be over- 
looked in canned foods. 

The use of any coloring-matter in canned food is an ob- 
jection, for many of the coal tar dyes used are harmful. 

Copper and zinc may be used to color canned peas. 
Lead from solder may be absorbed by canned foods. Acids 
of the foods often erode the tin in which they are con- 
tained and preservatives such as sulphuric, boric and 
salicylic acids are sometimes used in these foods. 

Purgatives, Cathartics and Laxatives. — The sale of 
purgatives, cathartics and laxatives probably averages the 
largest of all the drugs of the present day, and the prin- 
cipal cause for the enormous demand for these prepara- 
tions is the widely prevailing malady, constipation, — the 
other reasons for their demand are small in number. 

In many cases it is a gain to purge the intestinal tract 
when reforming the intestinal flora. At other times quick 
evacuation is demanded for special reasons. But cathar- 
tics and laxatives as a regular regime should be highly 
discouraged, for they lessen putrefaction only for the mo- 
ment, and the constipated condition is aggravated rather 
than lessened. 

Since, however, there are cases in which a limited num- 
ber of administrations of a cathartic or laxative are bene- 
ficial, the following classifications are enumerated, with a 
few comments respecting the advisability of each. 

Catharsis is an exaggerated activity or stimulation of 
the normal function of the intestines, and consequently its 
action produces irritation and inflammation in a greater 
or less degree. Therefore, the drug which will produce 
the desired effect with the least degree of irritation and 
inflammation and injury throughout the body is the one 



172 NUTRITION AND SPECIFIC THERAPY 

that should be chosen. A cathartic is a laxative in a 
large amount. It acts either by increasing the amount 
of fluid in the intestines or by increasing the activity of 
peristalsis. The increase of fluid is drawn from the sur- 
rounding blood-vessels. 

Classification of the Principal Organic Laxatives 
and Cathartics 

1. Cathartics Derived from Anthracene. — Senna, Cas- 
cara Sagrada, Rhubarb, Aloes, Frangula. — Cascara 
sagrada and rhubarb are the least irritating. They affect 
the large intestines principally in about 5 hours, sometimes 
8—12 hours. There may be a certain amount of griping, 
but no severe inflammation, and they are best administered 
at night. They may be present in the milk of nursing 
mothers. 

2. Purgative Oils. — Castor Oil, Croton Oil. — They 
affect principally the small intestines. 

These oils are hydrolyzed in the intestines, with the 
production of free'fatty acids which are irritating. Croton 
oil is generally far too violent, and causes severe griping; 
castor oil produces no griping, and is recommended in 
cases of abdominal pain. 

Castor oil produces action in 3-6 hours and croton oil 
in 1-2 hours. Castor oil is generally given at night. 
Both may be present in the milk of nursing mothers. 

3. Olive Oil, Cotton-Seed Oil. — They affect the small 
intestines. 

These are laxatives and also foods. Ten to fifteen c.c. 
(Y 2 oz.) a day are given in the case of a young infant. 
One-half to one wine glass is given in the case of an adult, 
although this may be insufficient. Should the patient be 
inclined towards obesity, this would be contraindicated. 
In such a case, liquid petroleum should be advised. 

These oils should be contraindicated in hypoacidity and 
diabetes (Chapter VII). 



MISCELLANEOUS SUBJECTS 173 

4. Resinous Cathartics. — Jalap, Podophyllum, Colo- 
cynth, Gamboge, Scammony. — These are very irritating 
and include the drastics. They affect principally the 
small intestines. They are administered at night or be- 
tween meals. 

5. Phenolphthalein (Carbolic Acid, Phthalic Anhy- 
dride and Sulphuric Acid). — This may be classified as a 
laxative, and is valuable in mild cases, and affects prin- 
cipally the large intestines in 8-12 hours. 

6. Agar- Agar, Manna, Liquid Petroleum, Mineral Oil 
or Liquid Paraffin. — They are used to soften the feces and 
increase their bulk. They are mild, non-irritating, un- 
absorbed, indigestible and incapable of decomposition by 
bacteria. They affect both the small and the large intes- 
tines in 8—12 hours, and are given at night or 2 hours 
after meals. When the desired effect is not obtained, the 
dose should be increased. 

7. Salines. — Salts of Tartaric and Citric Acids. — 
These affect both the small and large intestines, and are 
very rapid in action. They may produce some griping. 
They are not absorbed. 

Rochelle Salts (sodium, potassium tartrate) and Citrate 
of Magnesia are well-known examples. 

8. Bran. 

Chemical Composition of Bran 

Per cent. 

Water 12.5 

Protein 16.4 

Pat 3.5 

Carbohydrate 43.6 (Varies) 

Mineral Matter 6.0 

Cellulose 18.0 

The carbohydrate content is variable, ranging in dif- 
ferent samples from 10-40 per cent and when this per- 
centage is low, naturally those of the other food principles 
are higher. 



174 NUTRITION AND SPECIFIC THERAPY 

Some of the cellulose gives rise to gas and acid, both of 
which are laxative. Bran absorbs water, thus increasing 
peristalsis. It is not irritating in cases of constipation 
without complication, although this is contrary to many 
statements. It is also an excellent food with its high 
content of protein, carbohydrate and mineral matter and 
a certain amount of vitamines A and B 10 (about six level 
tablespoons served in hot water or with fruit at breakfast). 
It is especially recommended by the author for "poor" 
teeth. 

If large amounts of fruits and vegetables do not relieve 
constipation, bran should be the first laxative recom- 
mended. If patients cannot be persuaded to eat it plain 
in hot water or mixed with some food such as prune sauce, 
then it should be made a part of every-day cookery, adding 
it to mush, cakes, cookies and breads. It can replace white 
flour to the extent of 50 per cent. 

A very generous portion of bran in hot water once a 
day, preferably at breakfast, and a pint of water drunk at 
night should relieve the majority of cases of obstinate 
constipation. 

Classification of Inorganic Cathartics 

1. Salines, or Hydragogne Cathartics. — Salts of Sul- 
phuric, Phosphoric and Carbonic Acids, "Milk of Mag- 
nesia" (mild) and Magnesium Oxid. — These affect both 
the small and large intestines, and are very rapid in action. 
They may produce some griping and are not absorbed. 

It is well to administer both the organic and inorganic 
salines before breakfast, allowing 1 hour for them to take 
action. They cause a marked increase of fluid from the 
blood into the intestines as a result of osmotic pressure, 
and also because of special properties peculiar to the salts. 

Epsom Salt and Pluto Water (sodium and magnesium 
sulphate principally) and Glauber's Salt (sodium sul- 

10 A. D. Stammers, Biochem. J., Vol. XV, Xo. 4, 1921. 



MISCELLANEOUS SUBJECTS 175 

phate) are well-known examples. Hunyadi Water is sim- 
ilar to Pluto Water. 

2. Mercurials. — Calomel (mild mercurous chloride), 
Blue Mass (more mild than calomel). Calomel acts prin- 
cipally on the duodenum in 2-8 hours. 

It is irritating to the mucous membrane of the intestines, 
and is best administered at night. 

Its value is attributed to its powerful action, and to its 
antiseptic properties. 

Calomel should be followed by a dose of one of the 
salines, that none may remain in the intestines. 

Except in special cases, the author considers the salines 
the best cathartics, as they are not absorbed, their action 
is thorough, and rapid, and they produce little irritation. 

Enemas. — Oil enemas and water enemas are given 
when the oral administration of cathartics is contraindi- 
cated by gastric and intestinal disturbances. They are 
given also' for their soothing action in excessive colonic 
and rectal irritation. The oil enema is not as effective 
as the water enema to soften the feces, and is not as well 
retained. 

Water enemas may be of several kinds, — plain water, 
salt water, soapy water and mixtures of water with mag- 
nesium sulphate and glycerin. 

Emetics. — Vomiting is often necessary to expel quickly 
the contents of the stomach. Drugs used for this purpose 
produce the effect in two different ways : first, by stimulat- 
ing the wall of the stomach, causing it to contract and 
expel the contents; secondly, through being absorbed into 
the blood, causing nerve impulses to be sent to the walls 
of the stomach to contract them. 

Ipecac is probably the most commonly used drug and 
is obtained from the roots of a plant of South America. 
The vomiting is due chiefly to cephaeline and emetine, ac- 
tive alkaloids of the drug. It acts principally on the lining 
of the stomach. A small portion may be absorbed. It is 



176 NUTRITION AND SPECIFIC THERAPY 

usually expelled for the most part from the stomach, and 
therefore is prevented from producing any harmful results 
through absorption. 

Ipecac is also used as a reliable specific for ameba in 
the intestines, emetine being the destructive principle. In 
this case it should be given in coated pills to prevent its 
acting on the stomach walls. 

Mustard is frequently used to produce vomiting, — about 
one tablespoon to a glass of warm water. The dose may 
be repeated if the desired effect is not obtained. 

Salt is often given in a concentrated form. 



INDEX 



Accessory food substances, 136, 

and see Vitamines 
Adulterations, food, 23 
Aerobic bacteria, in digestive 

tract, 59 
Agar-agar, 173 
Alanine, 3 

Albumin, in milk, 100 
Albumin water, recipe for, 157 
Albuminized orange or grape 

juice, recipe for, 158 
Alcohol, effects of, 69 
Almond milk, compared with 
cow's milk, 154 
composition of, 154 
preparation of, 153 
Amino-acids, in gliadin, 3 
in legumin, 3 
in proteins, 3, 18 
in zein, 3 
Anachlorhydria, diet in, 78 
Anaerobic bacteria, in digestive 
tract, 59 
facultative, 59 
number varies with diet, 61 
Anemia, pernicious, diet in, 83 
due to lack of vitamines, 137 
theories of, 83, 84, 85 
Animal protein, 4 
absorption of, 4 
Anthracene, cathartics derived 

from, 172 
Antineuritic vitamines, 141, and 
see Vitamines, water-solu- 
ble B. 
Antiputrefactive diet, 51 
Antirachitic vitamines, 138, and 
see Vitamines, fat-soluble 



Antiscorbutic vitamines, 141, 
and see Vitamines, water- 
soluble C 
Antiscorbutics, 144 
Antitoxic glands, in auto-intox- 
ication, 47, 50 
Appendicitis, diet in, 78 
Apple water, recipe for, 158 
Arginine, 3 

Arteriosclerosis, diet in, 95 
Aspartic acid, 3 
Assimilation of foods, 16 
Asthma, diet in, 87 
Auto -intoxication, 46 

antitoxic glands in, 50 

caused by bacteria, 49 

caused by fermentation, 49 

caused by digestive disturb- 
ances, 48 

caused by putrefaction, 49, 50 

definition of, 47 

glands of internal secretion in, 
48 

"immunizing glands" in, 47 

lacto-farinaceous diet in, 51 

summary of, 52 

symptoms of, 55 

treatment of, 51 

types of, 47 

Bacillus, acidophilus, 60 

aerogenes capsulatus, 60, 61, 

62, 64 
aerogenes lactis, 60, 61 
bifidus, 60, 61 
bulgaricus, 66 
coli, 60, 61, 62, 63, 64 
perfringens, 60 
proteus vulgaris, 61 



177 



178 



INDEX 



Bacillus, putrificus, 61, 62 

welchii, 60 
Bacteria, and see Intestinal 
flora 

aerobes, in digestive tract, 59 

anaerobes, in digestive tract, 
59 

cause of auto-intoxication, 49 

facultative anaerobic, in diges- 
tive tract, 59 

in digestive tract, 58 

in intestines, 49, 50 

in milk, 60 
Bacteriology of digestive tract, 

58 
Baked lentils, recipe for, 151 
Baking, 27 

Beef, calorific value of, 13 
Beri-beri, due to lack of vita- 
mines, etc., 137, 141 
Blue mass, 175 
Boiling, 26, 27 
Bottles, feeding, care of, 124 
Botulism, 170 
Bran, 173 

composition of, 173 
Bread, calorific value of, 13 
Breweri ' yeast, 161 
Bronchitis, diet in, 86 
Broths, meat, not for children, 

130 
Butter, calorific value of, 13 

Caffeine, 71, 72, 73 

effects of, 68 
Calcium, in cereals, 38 

in fruits, 37 

in milk, 24, 101, 119 

in vegetables, 37 

lack of, in scurvy, 143 

requirement of body, 25 
Calcium caseinate, in milk, 81 
Calomel, 175 
Calories, defined, 11 

large, 11 

number required, 13, 15 

small, 11 
Calorific value of foods, 11 

to calculate, 12 



Cane sugar, 7 

effects of, 69 
Canned foods, 168 
Carbohydrates, 7 

calorific value of, 11 

classification of, 7 

combustion of, 9 

purpose of, 9 

source of, 9 

stools, 113 
Caries, dental, and vitamines, 

146 
Casein, in milk, 100 
Castor oil, 172 
Cathartics, abuse of, 71 

derived from anthracene, 172 

hydragogue, 174 

inorganic, classification of, 
174 

organic, classification of, 172 

resinous, 173 
Celluloses, 9 

effect of heat on, 21 
Cereal water compared with 

milk, 118 
Cereals, as food, 129 

calcium in, 38 

composition of, 43 

iron in, 37 

lecithin in, 100 
Centrifuged milk, 112 
Certified milk, 112 
Cheese, composition of, 43 
Chestnut puree, recipe for, 150 
Chestnuts, composition of, 150 
Children's diet, 96, 130 

at 1 year old, 127 

in 1st year, 127, 131 

in 2nd year, 131, 132, 133 

in 3rd year, 131 

in 4th year, 131 

rules for, 131 

with milkj 133 
Children, drinks for, 157 
Chlorophyll, 72 
Chocolate, 73 
Citrate of magnesia, 173 
Cocoa, composition of, 73 
Coconut, 159 



INDEX 



179 



Coffee, composition of, 72 

effects of, 68 
Colitis, diet in, 78 
Combustion of carbohydrates, 9 
Complete proteins, 18 
Condensed milk, 115 
Condiments, effects of, 69 
Constipation, 38, 174 
Cookies, oatmeal, recipe for, 156 
Cooking, effects of, 20 

of foods, 20 

of vegetables, 26 
Cotton seed oil, 172 
Cow's milk, and see Milk 

compared with almond milk, 
154 

compared with cereal water, 
118 

compared with human milk, 
98, 118 
Croton oil, 172 
Currant water, recipe for, 158 
Cystine, 3 

Deficiency diseases, 137 
Dental caries, and vitamines, 146 
Dextrins, 8 
Dextrose, 7 

Diabetes, Crof tan's views on, 92 
diet in, 88 
Allen's, 89 
Joslin's, 88 
von Noorden's, 90 
Lenne's method in diabetes, 

94 
Sajous' views on, 91, 93 
Woodyatt's method in dia- 
betes, 94 
Diarrhea, infantile, 81 
causes of, 81 
diet in, 81 
varieties of, 81 
Diet, and see Feeding 
antiputrefactive, 51 
for children, 96, 130 
at 1 year old, 127 
in 1st year, 127, 131 
in 2nd year, 131, 132, 133 
in 3rd year, 131 



Diet, for children in 4th year, 131 

rules for, 131 

with milk, 133 
for infants, 96 
in anachlorhydria, 78 
in appendicitis, 78 
in arteriosclerosis, 95 
in asthma, 87 
in auto-intoxication, 51 
in bronchitis, 86 
in colitis, 78 
in common diseases, 76 
in diabetes, 88 

Allen's, 89 

Joslin's, 88 

von Noorden's, 90 
in diarrhea, infantile, 81 
in dilatation of stomach, 79 
in diphtheria, 86 
in eczema, 87 
in enteritis, 78 
in fevers, 86 
in flatulency, 79 
in gall-stones, 79 
in gastric ulcer, 78 
in gastritis, 78 
in gout, 83 
in heart diseases, 79 
in hyperchlorhydria, 76 
in hypochlorhydria, 77 
in infantile diarrhea, 81 
in influenza, 86 
in jaundice, 79 
in kidney diseases, 82 
in measles, 86 
in migraine, 78 
in pernicious anemia, 83 
in pneumonia, 86 
in scarlet fever, 86 
in tuberculosis, 86 
in typhoid fever, 86 
in urticaria, 87 
in whooping cough, 86 
lacto-farinaceous, in auto-in- 
toxication, 51 
lacto-vegetarian, versus meat 

diet or mixed diet, 29 
meat, versus vegetarian or 
lacto-vegetarian diet, 29 



180 



INDEX 



Diet, mixed, versus vegetarian or 
lac to -vegetarian diet, 29 
vegetarian, 39 

objections to, 14 
versus meat diet or mixed diet, 
29 
Dietaries, standard, 14 
Digestion, 17 

of milk, 110 
Digestive disturbances, as cause 

of auto-intoxication, 48 
Digestive tract, bacteriology of, 

58 
Dilatation of stomach, diet in, 

79 
Diphtheria, diet in, 86 
Disaccharides, 7 
Drinks, for children, 157 
for invalids, 157 
iced, effect of, 70 



Eczema, diet in, 87 

Egg lemonade, recipe for, 158 

Eggs, composition of, 43 
lecithin in, 100 
souffled, recipe for, 156 
steamed, recipe for, 156 
timbales, recipe for, 156 

Emetics, 175 

Enemas, 175 

Enteritis, diet in, 78 

Epsom salt, 174 

Evaporated milk, 115 



Facultative anaerobic bacteria, 

in digestive tract, 59 
Fat, or Fats, 5 

absorption of, 6 

calorific value of, 11 

decomposition of, 6 

digestibility of, 6 

edible, smoking temperature 
of, 6 

effect of heat on, 20 

in milk, 100 

melting point of, 5 

source of, 7 



Feeding, and see Diet, and 
Foods 
of infants, 96 

formulas for, 117 

in 1st month, 124 

in 2nd month, 125 

in 3rd and 4th months, 125 

in 5th and 6th months, 125 

in 7th, 8th, and 9th months, 

125 
in 10th month, 126 
in 11th month, 126 
in 12th month, 126 
rules for, 113 
Feeding bottles, care of, 124 
Fermentation, auto -intoxication 

due to, 49 

Fevers, diet in, 86 

Flatulence, diet in, 79 

Foods, adulteration of, 23 

assimilation of, 16 

calorific value of, 11 

to calculate, 12 
canned, 168 
composition of, 2 
cooking of, 20 
digestion of, 16, 17 
effect of heat on, 20 
iron in, 36 
lime in, 37 
preparation of, 20 
Formulas for infant feeding, 117 
Fructose, 7 

Fruits, calcium in, 37 
iron in, 37 
organic acids in, 11 
Fruit sugar, 7 



Galactose, 7 

Gall-stones, diet in, 79 

Gastric ulcer, diet in, 78 

Gastritis, diet in, 78 

Gelatin, as supplement of pro- 
tein, 107 

Glands, antitoxic, in auto-intox- 
ication, 47, 50 
ft immunizing, " in auto-intoxi- 
cation, 47 



INDEX 



181 



Glands, of internal secretion, in 

auto-intoxication, 48 
Glauber's salt, 174 
Gliadin, amino-acids in, 3 
Glucose, 7 
Glutamic acid, 3 
Glycocoll, 3 
Glycogen, 8 
Goat's milk, as food for infants 

and children, 134 
composition of, 134 
Goiter, as influenced by iodin, 

166 
Gout, diet in, 83 

oxalic acid in, 75 
Grape juice, albuminized, recipe 

for, 158 
and egg, recipe for, 159 
Grape sugar, 7 
Grape water, recipe for, 158 
Grape yeast, 161 
Gruels, for infants, 156 

for invalids, 156 
Gums, 8 

Heart diseases, diet in, 79 
Heat, effect of, on cellulose, 21 
effect of, on fats, 20 
effect of, on proteins, 20 
effect of, on starch, 20 
Hexoses, 7 
Histidine, 3 

Honey, composition of, 73 
Hordein, amino-acids in, 3 
Hot drinks, effect of, 70 
Human milk, compared with ce- 
real water, 118 
compared with cow's milk, 98, 
118 
Hunger pangs, 68 
Hydragogue cathartics, 174 
Hyperchlorhydria, diet in, 76 
Hypochlorhydria, diet in, 77 

Iced drinks, effect of, 70 
' l Immunizing ' ' glands, in auto- 
intoxication, 47 
Indican, 49 
Indicanuria, 55 



Infant's diet, 96 
Infant feeding, formulas for, 
117 

in 1st month, 124 

in 2nd month, 125 

in 3rd and 4th months, 125 

in 5th and 6th months, 125 

in 7th, 8th, and 9th months, 
125 

in 10th month, 126 

in 11th month, 126 

in 12th month, 126 

rules for, 113 
Infant's gain in weight in first 

year, 122 
Infants, gruel for, 156 
Infantile diarrhea, 81 

causes of, 81 

diet in, 81 

varieties of, 81 
Influenza, diet in, 86 
Internal secretion, glands of, in 

auto -intoxication, 48 
Intestines, bacteria in, 49, 50, 

61 
Intestinal flora, reforming the, 
65 

rules for, 67 
Inulin, 9 
Invalids, drinks for, 157 

gruels for, 156 
Iodin, influence on goiter, 

166 
Ipecac, 175 
Iron, in foods, 36 

requirements in body, 25 
Isoleucine, 3 

Jaundice, diet in, 79 
Jelly and ice, recipe for, 157 

Kidney diseases, diet in, 82 

Lactic acid, bacteria, 65, 66 
preservative effect of, 66 
to obtain, in colon, 66 
value of, 65 

Lacto-farinaceous diet in auto- 
intoxication, 51 



182 



INDEX 



Lacto-vegetarian diet, versus 
meat diet or mixed diet, 
29 
Lacto-vegetarianism, 40 
Lactose, 8 
Laxatives, 171 

classification of, 172 
Lecithin, in cereals, 100 

in eggs, 100 

in legumes, 100 

in milk, 98, 99 
Legumes, composition of, 44 

lecithin in, 100 

pur6e, recipe for, 157 
Legumin, amino -acids in, 3 
Lemonade, egg y recipe for, 158 
Lentil toast, recipe for, 151 
Lentils, baked, recipe for, 151 
Leucine, 3 
Levulose, 7 
Lime, in foods, 37 
Lime starvation, 24 
Lime water, addition of to in- 
fant's food, 120 
Liquid paraffin, 173 

petroleum, 173 
Lupeose, 8 
Lysine, 3 

Magnesia, citrate of, 173 
Magnesium requirements of 

body, 26 
Malt soup extract, 115 
Malt sugar, 8 
Malted milk, 115 
Maltose, 8 

for infants, 115 
Manna, 173 
Mannose, 7 
Measles, diet in, 86 
Meat broths, not for children, 

130 
Meat diet, versus vegetarian or 

lacto-vegetarian diet, 29 
Meats, composition of, 43 

not for children, 130 
Melibiose, 8 
Mercurials, 175 
Migraine, diet in, 78 



Milk, albumin in, 100 

almond, composition of, 154 
compared with cow's milk, 

154 
preparation of, 153 

bacteria in, 60 

calcium in, 24, 101, 119 

calcium casemate, 81 

casein in, 100 

centrifuged, 112 

certified, 112 

children's diet with, 133 

composition of, 43, 99 

condensed, 115 

cow's compared with human, 
98, 118 
compared with almond milk, 
154 

digestion of, 110 

evaporated, 115 

fat in, 100 

goat's, as food for infants and 
children, 134 
composition of, 134 

human, compared with cow's 
98, 118 

lecithin in, 98, 99 

malted, 115 

mineral matters in, 101 

modification, 122 

pasteurized, 104 
advantages of, 105 
characteristics of, 104 
digestion of, 110 
disadvantages of, 105 

phosphorus in, 101, 120 

protein in, 100 

question, 127 

raw, advantages of, 105 
compared with sterilized 

milk, 111 
dangers of, 112 
digestion of, 110 
disadvantages of, 105 

sterilized, 102 

advantages of, 103 
chemical changes in, 102 
compared with raw milk, 
111 






INDEX 



183 



Milk, sterilized, digestion of, 
110 

streptococci in, 61 
Milk sugar, 8 
Mineral matters, 10 

in milk, 101 

source of, 10 
Mineral oil, 173 
Mixed diet, versus vegetarian or 

lacto-vegetarian diet, 29 
Modification of milk, 122 
Molasses, 70 
Monosaccharides, 7 
Mucilages, 9 
Mustard, as an emetic, 176 



Nest eggs, recipe for, 154 
Neurasthenia, due to lack of 

vit amines, 137 
Nipples, care of, 124 
Nitrogen equilibrium, 15 
Nutrition, explanation of, 1 
Nuts, composition of, 45, 150 
Nut, date, and bran muffins, 

recipe for, 154 



Oatmeal cookies, recipe for, 156 
Oatmeal toast, recipe for, 152 
Oil, castor, 172 

cotton seed, 172 

croton, 172 

mineral, 173 

olive, 172 

physiological action of, 162 

purgative, 172 
Olive oil, 172 

physiological action of, 162 
Orange juice, albuminized, re- 
cipe for, 158 

as antiscorbutic, 144 

as infant food, 109, 111 
Organic acids, in fruits and 

vegetables, 11 
Overeating, 68 
Oxalic acid, in gout, 75 
Oxaluria, 75 
Qxyproline, 3 



Paraffin, liquid, 173 
Pasteurized milk, 104 

advantages of, 105 

characteristics of, 104 

digestion of, 110 

disadvantages of, 105 
Pectin, 72 
Pellagra, cause of, 144 

deficiency disease, 144 

due to lack of vitamines, etc., 
137 
Pernicious anemia, diet in, 83 

due to lack of vitamines, 137 

theories of, 83, 84, 85 
Petroleum, liquid, 173 
Phenolphthalein, 173 
Phenylalanine, 3 

Phosphorus, deficiency of in 
etiology of rickets, 140 

in milk, 101, 120 
Pneumonia, diet in, 86 
Polysaccharides, 8 
Potassium requirements in bodv, 

26 
Potato, as food, 155 

versus rice, as a food, 154, 
155 
Preparation of food, 20 
Proline, 3 
Protein, 2 

amino-acids in, 3, 18 

amount required, 4 

animal, 4 

calorific value of, 11 

complete, 18 

effect of heat on, 20 

gelatin as supplement of, 107 

in milk, 100 

source of, 5 

vegetable, 4 
Ptomaines, origin of, 49 
Purees, legume, recipe for, 

157 
Purgative oils, 172 
Purgatives, 171 

Putrefaction, auto-intoxication 
due to, 49, 50 

types of chronic, 64 
Pyorrhea and vitamines, 146 



184 



INDEX 



Ramnose, 8 

Eaw milk, advantages of, 105 

compared with sterilized milk, 
111 

dangers of, 112 

digestion of, 110 

disadvantages of, 105 
Recipes, 150 

foT albumin water, 157 

for albuminized grape juice, 
158 

for albuminized orange juice, 
158 

for almond milk, 153 

for apple water, 158 

for baked lentils, 151 

for chestnut puree, 150 

for currant water, 158 

for drinks, 157 

for egg lemonade, 158 

for egg timbales, 156 

for grape juice and egg f 
159 

for grape water, 158 

for gruels, 156 

for jelly and ice, 157 

for legume purees, 157 

for lentil toast, 151 

for nest eggs, 154 

for nut, date, and bran muf- 
fins, 154 

for oatmeal cookies, 156 

for oatmeal toast, 152 

for souffled eggs, 156 

for soy bean cookery, 152 

for soy bean croquettes, 151 

for steamed eggs, 156 

for strawberry whip, 158 
Resinous cathartics, 173 
Rhubarb, 73 

Rice, as substitute for potato, 
154, 155 

unpolished, 155 
Rickets, deficiency of phosphorus 
in etiology of, 140 

due to lack of vitamines, etc., 
137 

etiology of, 138, 139 
Rochelle salts, 173 



Saccharose, 7 
Salines, 173, 174 
Salt, as an emetic, 176 
Salt in food, excessive use of, 
166 

value of, 165 
Scarlet fever, diet in, 86 
Scurvy, classification of, 143 

due to lack of vitamines, etc., 
137 

etiology of, 141 

lack of calcium in, 143 
Serine, 3 

Sodium requirements in body, 25 
Sorbose, 7 
Sorghum, 70 

Souffled eggs, recipe for, 156 
Soy bean, chemical composition 
of, 153 

cookery, 152 

croquettes, recipe for, 151 
Spinach, 73 
Starches, 8 

cooking of, 129 

effect of heat on, 20 
Steamed eggs, recipe for, 156 
Steaming, 27 
Sterilized milk, 102 

advantages of, 103 

chemical changes in, 102 

compared with raw milk, 
111 

digestion of, 110 

disadvantages of, 103 
Stewing, 27 
Stomach, dilatation of, diet in, 

79 
Stools, carbohydrate, 113 

of infants, 114 
Strawberry whip, recipe for, 158 
Streptococci in milk, 61 
Sugar, and see Cane sugar 

cane, 7, 69 

fruit, 7 

grape, 7 

indigestion from, in infants, 
114 

malt, 8 

milk, 8 



INDEX 



185 



Tannic acid, 71, 72, 73 
Tannin, effects of, 68 
Tea, composition of, 72 

effects of, 68 
Tetrasaccharides, 8 
Timbales, egg, recipe for, 156 
Tissue builders, 4 
Tobacco, effects of, 69 
Top milk, use of for infants, 

121 
Trehalose, 8 
Trisaccharides, 8 
Tryptophane, 3 
Tuberculosis, diet in, 86 
Typhoid fever, diet in, 86 
Tyrosine, 3 

Ulcer, gastric, diet in, 78 
Unpolished rice, 155 
Urticaria, diet in, 87 

Valine, 3 

Value of foods, calorific, 11 

to calculate, 12 
Vegetable protein, 4 

absorption of, 4 
Vegetables, calcium in, 37 

composition of, 45 

cooking of, 26 

iron in, 37 

organic acids in, 11 
Vegetarian diet, 39 

objections to, 41 

versus meat or mixed diet, 29 
Vitamines, 136 

A, low in potato, 155 
A and B in bran, 174 
antibodies, relation to, 40 
antineuritic, 141 
antirachitic, 138 
antiscorbutic, 141 

auto -intoxication, relation to, 
52 

B, in yeast, 160 

B, low in milk, 161 



Vitamines, chlorophyll, associa- 
tion with A, 72 
D, 146 

dental caries and, 146 
diabetes, may influence, 89 
diseases due to lack of, 

137 
fat-soluble A, 137, 138 

foods in which found, 138 
foods lacking in, 137 
in cooking, destroyed or lost, 

24 
in cooking, vegetables, etc., 28 
pyorrhea and, 146 
in mixed diet, 12 
in pasteurization, partly de- 
stroyed, 104 
necessary for growth and 

health, 16 
removed in milling, 44 
water-soluble B, 137, 141 

foods in which found, 141 
water-soluble, C, 137, 141 
aging of, 142 
effect of heat on, 142 
foods in which found, 142 

Water, 10 

when to drink, 70 

Weight of infant, gain in dur- 
ing first year, 122 

Wheat water, in infant foods, 
116 

Whooping cough, diet in, 86 

Xerophthalmia, due to lack of 
vitamines, etc., 137, 139 

Yeast, brewers', 161 

composition of, 160 

grape, 161 
Yeast cure, 159, 160, 162 

Zein, amino-acids in, 3 



